Lnuary 1967
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habilitation
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2 THE CANADIAN NURSE
1435 St. Alexander St.,
Montreal, Que.
JANUARY 196:
The
Canadian
Nurse
'-
o
A monthly journal for the nurses of Canada published
in English and French editions by the Canadian Nurses' Association
Volume 63, Number 1
January 1967
26 Habilitation of Thalidomide Children:
The Nursing Approach M. O'Brien, M. Owens, and J. Ralph
29 Impact of Cerebral Palsy on Patient
and Family W.A. Hawke
P. Grondin and C. Meere
32 Recent Advances in Heart Surgery
36 Intensive Care Unit in Cardiovascular
Surgery
39 Varicose Veins of the Lower Limb
43
45
50
Nursing Care in Varicose Vein Surgery
Effectiveness of Nursing Visits
to Primigravida Mothers
Project Bed Rest
C. Boisvert
P. Dionne
M. Rodrigue
L.S. Brown
L. Dahl, M. Smith, B. Fowle
1. Hutchison, R. Graham, and D. Black
The views expressed in the various articles are the views of the authors and do not
necessarily represent the policies or views of the Canadian Nurses' Association.
4 Letters
7 News
16 Names
22 New Products
23 Dates
25 Editorial
53 Books
55 Films
56 Accession List
1966 Index
II Official Directory
Executive Director: Helen K. Mussallem .
Editor: VIrginia A. Llndabury . Assistant
Editor: Glennls N. Zilm . News Editor: June
I. Ferguson . Editorial Assistant: Carla D.
Penn . Circulation Manager: Plerrette Hotte .
Advertising Manager: Ruth H. Baumel. Sub-
scription Rates: Canada: One Year. $4.50; two
years, $8.00. Foreign: One Year, $5.00; two
years. $9.00. Single copies: SO cents each.
Make cheques or money orders payable to
The Canadian Nurse . Change of Address:
Four weeks' notice and the old address as
v.: ell as t
e new are necessary. Not respon-
sIble for Journals lost in mail due to errors
in address.
Manuscript Information: "The Canadian
Nurse" welcomes unsolicited articles. Alt
manuscripts should be typed, double-spaced.
on one side of unruled paper leaving wide
margins. Manuscripts are accepted for review
for exclusive publication. The editor reserves
the right to make the usual editorial chan
es.
Photo
raphs (glossy prints) and graphs and
diagrams (drawn in india ink on white paper)
are welcomed with such articles. The editor
is not committed to publish all articles sent,
nor to indicate defimte dates of publication.
Authorized as Second-Class Mail bv the Post
Office Department, Ottawa, and for_payment
of postage in cash. Postpaid at Montreal.
Return Postage Guaranteed. SO The Driveway,
Ottawa 4, Ontario.
@ Canadian Nurses' Association, 1966
An item appearing recently in
a French-language newspaper
reports that married women in
Sweden are seriously questioning
whether it is worth their while to
seek gainful employment.
Apparently income taxes are in-
creased disproportionately when
more than one member of the
family brings home a paycheck.
Moreover, the Swedish women
complain that child care costs, a
necessary expense for working
mothers with young children,
cannot be deducted from income
tax.
Similar deterrents to employment
of married women are found in
Canada. The income tax structure
was organized at a time when the
man in the home was the sole
breadwinner, and has not been
revised to keep apace of the
changing role of women in
the economy.
After examining present income
tax policy as it pertains to married
women, we became convinced that
its irrelevancies could be discussed
adequately only in a full page
editorial (page 25).
We believe that a revised Income
Tax Act that recognizes the role
of married women in the labor
force will benefit the country's
economy as well as individuals and
their families. We realize, also,
that taxation procedures inflict
hardships on many different groups
within the labor force. In this
article we are dealing primarily
with married women who are
nurses, because we believe that
anything that inhibits the re-entry
of professional nurses into a
practice already short of practition-
ers is detrimental to Canadian
health services and to Canada.
- Editor.
THE CANADIAN NURSE 3
JANUARY 1967
letters
{
Letters to the editor are welcome.
Only signed letters will be considered for publication
Name will be withheld at the writer's request.
Nurgentsl
Dear Editor:
I was delighted to read in your October
issue that male nurses are likely to be wel-
comed into the study and work of obstetrical
nursing.
Seventy years ago I started my nursing
career in the Samaritan Hospital for Women
in Glasgow, Scotland and I learned a lot
that was good to know about women and
also men. Very soon I felt angry that male
nurses in military hospitals were called
"orderlies." I know how kind men can be
and, even with their extra strength, how
gently they can handle patients - often
better than women. Has anyone thought
of calling them "nurgents?" With every good
wish for your magazine. - Jean McMartine
Weir, B.C.
Dear Editor:
We were interested to read the article
"Why not obstetric nursing for male stu-
dents?" (October 1966.)
As we are men in nursing, we are pleased
to see articles such as this appearing in
the magazine. We were surprised to learn
that only an estimated 60 percent of male
nurses have had obstetrical nursing exper-
ience. We agree that the rationale for this,
"that the obstetrical patient would be embar-
rassed if a male nurse attended to her nurs-
ing care needs" is not sound. We wonder
how these schools reason that women who
have had male nurses attending to them in
the case room, would be more embarrassed
in tbe postpartum period.
There are six men enrolled in the nursing
course at the Regina Grey Nuns' School of
Nursing, Regina, Saskatchewan. Two are
presently in obstetrical nursing. It is man-
datory that we take the full obstetric course,
theory and practice.
We perform total nursing care - anti-
and postpartum, with the exception of peri-
neal care. We will also be having the reg-
ular experience in the case room, nursery
and premature nursery.
We have exprienced complete acceptance
by the mothers and the present ward staff.
We are convinced that all schools of nurs-
ing should attempt to prepare aU their stu-
dents, male or female, to be fully qualified
with a basic understanding in all nursing
areas. - Dave Hunter, R.P.N., and Bill
Ayotte, R.P.N., senior nursing students,
Regina Grey Nuns' School of Nursing,
Reciprocity wanted
Dear Editor:
We are concerned with the provincial
4 THE CANADIAN NURSE
and international re-registration of nurses.
It seems to us that pettiness and nastiness
abound. How about action on international
registration ?
We are all members of the International
Council of Nurses, and each delegate is
recognized as a professional nurse. Is it not
odd that we should find such difficulty in
accepting each other outside Geneva?
We suggest a blitz here and now: All
Canadian nurses should apply for registra-
tion in at least one other province and one
other country. This action would give the
individual nurse experience with this pro-
blem; she would also discover that nurses
around the world are more alike than dif-
ferent !
With this experience, nurses would be
eager to change the laws that presently bind
us, and it could provide the impetus to
break the existing hiatus. - Bob Brown,
R.M.N., S.R.N., Reg.N., and Phil Gower,
Reg.N., The University of Western Ontario
School of Nursing, London, Onto
Unwed Father
Dear Editor:
Attention is continually being focused on
the unmarried mother - her problems,
fears, and responsibilities. I believe it is
time that an investigation be made into the
role of the putative or unmarried father.
Granted, he can escape from the situation
more easily than an unmarried mother, but
he does not escape from thõse problems
that caused his behavior in the first place.
The putative or unmarried father is a
man who produces a child as a result of
intercourse out of wedlock and who subse-
quently fails to marry the mother before
the birth of the child.
Until recently, the only consideration given
to the problems of the putative father has
been from a moral standpoint. The psycho-
logical aspects are now coming under in-
vestigation. A boy guilty of promiscuous
behavior may be using girls to satisfy needs
that were neglected in his early upbringing
- needs for affection, attention, indepen-
dence and acceptance. Other theories suggest
that the putative father, although so insecure
that marriage would be unthinkable, pro-
duces a child to prove to himself that he is
ready for marriage.
Society seems to regard the unmarried
father as a man who has "let the woman
down" by not marrying her. This is often
the case, but there are also many cases ill
which the boy would be willing to marry
the girl but she refuses or her parents will
not allow it. In other cases the couple
mutually agree not to marry.
Looking on the financial side of things,
there is the unmarried father whose cons-
cience is headed by cash settlements. When
this prostitute pattern is brought into the
picture, the child becomes only the mother's
in the sight of both parents.
In contrast, there are men with true
parental feeling for whom a cash settlement
would do nothing but increase their sense of
guilt. In the case of a young man who
knows enough of modern psychology to
realize the effect of deprived parenthood on
a child, this sense of guilt may have a des-
tructive effect on his later relationships with
his legitimate children.
The unmarried father will find it hard
to go to a welfare office for help. He
always expects severe treatment or at least
trouble. Knowing that society still regards
him in a criminal light, he tends to stay
away from any official person or body no
matter how much he needs help. It is easy
to see that some of the apparent irresponsi-
bility of the unmarried father is due to the
fear he has of social censure. He particularly
distrusts women social workers because he
does not think that they will understand the
man's point of view.
[ believe that if the many mysteries sur-
rounding the unmarried father are to be
removed, society must adopt a new attitude.
Instead of isolating the putative father, it
should treat father, mother, and child as an
originally linked problem. Only with such an
approach can society avoid the increasing
number of adoptions and help to establish
new families from people who originally saw
nothing ahead but a life filled with problems
that they could not solve. - Miss Helen
Staat, intermediate nursing student, Royal
Columbian Hospital, New Westminster, B.C.
Unfair to blame nurses
Dear Editor:
I just read the distressed reader's letter
in the November issue, complaining about
the indifference of a nurse toward her while
she was in labor.
I do not like to see a hospital described
as turning out poor nurses - as the reader
implies in her letter - because I think that
rather the opposite is true; nor do I like
to see somebody jumping to the conclusion
that all nurses are bad nowadays, because
one nurse possibly slipped up somewhere.
[ said "possibly" because, after all, the nurse
probably had her instructions from the doc-
tor, and they might well have been different
from what the patient thought they were.
Any nurse who has worked in obstetrics
(Continued on page 6)
JANUARY 1967
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THE CANADIAN NURSE 5
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JANUARY 1%7
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letters
(Continued from page 4)
has come across the case where the doctor,
for various reasons, does not want to give
anything for pain until he absolutely has
to. And funhermore, where was the lady's
doctor? Did he induce labor - at night! -
and then go home? And did he phone back
or come in person to che;:k his patient's
progress? She says nothing about that.
I think it is most unfair of her to put
all the blame for her neglect, if there was
any, on the nurses. They were probably
overworked. and expected her, of all pa-
tients, to have understanding in the situation.
The only thing that bothers me in that letter
is that the nurse who came on duty at 11 :30
P.M. did not go in to check the patient.
Probably there was a good reason why she
didn't. but it would have been better if she
had. Above all, it would have reassured the
patient to know that somebody was keeping
an eye on her. From the tone of the letter it
seems obvious that reassurance was what she
needed most. - Mrs. M.E. Mueller, R.N.,
Nonh Battleford, Saskatchewan.
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samples and literature
6
THE CANADIAN NURSE
Refresher course in Manitoba
Dear Editor:
In answer to the letter from "R.N. Mani-
toba" and her comment regarding refresher
courses (September 1966): St. Boniface Gen-
eral Hospital will be conducting its fourth
six-week refresher course in February and
early March of 1967.
Any nurses from the Winnipeg area inter-
ested in this course can obtain more infor-
mation by writing to the Co-ordinator, In-
service Education, St. Boniface General Hos-
pital, St. Boniface, Manitoba. - (Mrs.) K.
De long. Winnipeg, Manitoba.
Compliments
Dear Editor:
We have noticed with great pleasure the
numerous innovations which have been in-
corporated into both The Canadian Nurse
and L'infirmière canadienne.
Furthermore, we appreciate that the
French edition is not a word for word
translation of the English.
We would like to congratulate each and
every member of the editorial staff, hoping
that they will keep up their enthusiasm in
order to maintain the spirit of the magazine
and make it even livelier. - Sister Claire
Bilodeau, Director of the School of Nursing.
Hôpital du St-Sacrement, Québec.
Dear Editor:
Every month after reading THE CANADIAN
NURSE I think that I should write to ex-
press my appreciation for the very fine
issues we are receiving. I have procrastinat-
ed long enough, so here are my sincere
thanks for a difficult job well done.
This letter was prompted by the opinion
expressed by Dr. R.W. Sutherland in his
article "Needed: Nurses Who Are Clinical
Specialists" (Sept. 1966). I agree with I
every word he wrote. - K. Deathe, Toron-
to, Onto
Dear Editor:
The Nursing Sisters' Association of Can-
ada, Montreal Unit, express appreciation and
thanks for the anicles and photographs
published in the November issue.
Greetings and good wishes to the staff
of THE CANADIAN NURSE. - Nancy Kennedy-
Reid, National President and I. O'Reilly,
President, Montreal Unit.
Dear Editor:
I have just received the September issue
of THE CANADIAN NURSE. I am an Alberta
graduate and am currently registered in B.C.
The new concepts that are prevalent in
nursing today never cease to amaze me.
I am proud to say I am a nurse, and also
a Canadian.
Keep up the good work, we all can learn
from one another. - E.M. Harrison, R.N.,
Chemainus, B.C. 0
JANUARY 1%7
news
Dublin-Born Nurse
to Study in Canada
Sister Genevieve, S.R.N., principal tutor
at the Mater Infirmorum Hospital, Belfast,
will study nursing education in Canada as
a result of winning the 1966 Glaxo Scholar-
ship administered by the British Common-
wealth Nurses' War Memorial Fund.
This is the eight successive year that
Canada has been chosen by a Glaxo Scho-
lar as a training center.
Sister Genevieve, who was presented with
her award by Queen Mother Elizabeth at a
birthday reception at St. James's Palace to
celebrate the 21st anniversary of the Fund,
will arrive in Montreal early in April. She
will study post-basic courses in obstetric
nursing, operating room nursing, and
psychiatric nursing at the Royal Victoria
Hospital.
The E500 scholarship will also take her
to Toronto, New York, Washington, D.C..
St. Louis, San Francisco, and Chicago.
The Glaxo Scholarship is one of several
available through the British Commonwealth
Nurses' War Memorial Fund. It was set up
in 1945 as a memorial to the 3,000 nurses
and midwives of the British Commonwealth
who lost their lives in the Second World
War. The Fund has to date sponsored over
150 scholars and two research fellows.
UWO School of Nursing
Sponsors Fifth Seminar
To assist senior nursing executives toward
better job performance, the school of nursing
of the University of Western Ontario has
arranged an II-day seminar June 12-23,
1967.
Sessions are planned for six days, Monday
through Saturday noon the first week; for
five days, Monday through Friday afternoon,
the second week. Featured speakers will
include Mother M. St. Michael, professor of
philosophy, Brescia College, UWO; Dr.
Catherine M. Norris, nurse educator and
author, formerly professor of nursing at
the University of New Mexico; Dr. R. Hodg-
son, associate profe.ssor of the school of
business administration, UWO; and Dr.
Elizabeth Hagen, professor of psychology
and eduoation at Columbia University.
Interspersed throughout the two-week
program will be lecture-discussion sessions,
group analyses of cases, films, role-playing
and individual guided study.
Enrollment will be limited to 75 appli-
cants who will be selected on the basis of
their present positions and responsibility for
administration. Efforts will be made to
select a representative group from nursing
JANUARY 1%7
0(
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'W'I
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Queen Mother Elizabeth presents the 1966 Glaxo Scholarship to Sister Gene-
vieve of Dublin. This scholarship, administered by the British Commonwealth
Nurses War Memorial Fund, will enable Sister Genevieve to study nursing
education in Canada during the coming year.
service administrators in hospitals, nursing
service administrators in public health, nurs-
ing education administrators, and adminis-
trators and consultants in professional or-
ganizations.
The course fee is $250 to include classes,
study materials, lodging, and meals. Appli-
cation forms, which should be completed
and returned to the School prior to March
I, 1967, are available upon request.
CNA Publishes Guide
for Two-Year Diploma Programs
A guide dealing with the development of
two-year diploma programs in eduoational
institutions has just been published by the
Canadian Nurses' Association.
Approved for publication at the pre-
convention executive meeting, it is designed
for educators considering such programs,
whether in a community college, junior
college, vocational school or technical school.
Called Guiding Principles fOr the Develop-
ment of Programs in Educational Institu-
tions Leading to a Diploma in Nursing. the
document covers planning and investigation,
organization and administration, faculty,
students, curriculum and instruction. and
physical facilities.
The publióation is available upon request
from the CNA. Price $1.00.
New Brunswick Nurses Take
Important Step in Nursing
Education
The New Brunswick Association of Regis-
tered Nurses has asked the provincial
government to take immediate steps to
implement the pIan for the education of
nurses and health workers generally, as ad-
vocated in Portrait of Nursing by Dr.
Katherine MacLaggan.
The nurses' request to government has
been supported by citizens' committees from
all areas of the province chaired by Dr.
Allan Sinclair of the University of New
Brunswick law faculty.
The proposals for the new system of edu-
cation concern a variety of health workers
described as Nurse Grade I, Nurse Grade II,
Wardkeeper and Ward Secretary.
Both nursing groups would be prepared
at the post high-school level within the
province's genel1al educational system. The
Nurse Grade I would constitute 75 percent
of the nursing complement and would be
eduoated in a two-year period at new health
institutes recommended for Saint John.
Moncton, and Campbellton. Twenty-five per-
cent of the nurses, called Nurse Grade II,
would be educated in New Brunswick's two
established university schools of nursing.
THE CANADIAN NURSE 7
news
The proposed heaith institutes wouid aiso
educate the ward secretary and other per-
sonnel for the health field and would be
administered by an independent council res-
ponsible to the minister of education.
Envisioned under the program would be
a phasing-out of existing schools of nursing
over a period of years when newly-trained
staff become available. It is estimated that
from the start at any given time, a period
of three years would be necessary for
implementation. Existing health personnel
trained under the present system would be
retrained and protected on staff while new
trainees would be trained under the propos-
ed new system.
The plan suggests that the first pilot
health institute be established in Saint John
because of important community facilities,
especially in an institute in close proximity
to St. Joseph's and the Saint John General
Hospitals.
A Moncton institute on or near the Uni-
versity of Moncton campus which would
provide easy access to hospitals, arts and
science facilities is recommended.
A third institute is invisioned in Camp-
bellton to serve between 300-400 students
at a cost of between one and two million
dollars.
The NBARN suggests that the capitaJ cost
of such institutes be born by the province
which would be able to avail itself of heaJth
resources grants from the federal govern-
ment.
The plan, which was published in 1965,
has been endorsed by the Canadian Nurses'
Association.
Alberta Nurses Serve in Africa
Two instructors from the Foothills Hos-
pital school of nursing are in Geneva being
briefed for World Health Organization as-
signments in West Africa.
Margaret Svennin
n and Terry Knapik
left Calgary New Year's Eve for WHO's
headquarters at the Palais des Nations.
Before taking up their two-year appointments
in Ghana and Gambia they will stop over
at Brazzaville in the Congo for further
orientation.
Miss Svenningsen will be teaching psy_
chiatric nursing at the University of Ghana.
This is pan of a two-year course for grad-
uate nurses. Her duties will include develop-
ing the mental health aspects of the cur-
riculum and also training a native African
counterpart.
Two hundred miles away, Miss Knapik
will be teaching public heaJth in the school
of nursing at Bathurst. She will also train
a native African counterpart and will be an
advisor to the Minister of Public Health
in Gambia.
8 THE CANADIAN NURSE
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Nurses Recognized by Order of St. John. Three prominent members of
the nursing profession pause for a photograph in the foyer of Government
House in Ottawa after the Annual Investiture of the Order of St. John in
Nov.ember. They are, left to right: M. Pearl Stiver, former executive director
of the Canadian Nurses' Association; M. Christine Livingston, former
director-in-chief of the VON, and Margaret M. Hunter, chief nursing
officer for St. John Ambulance in Canada. Miss Stiver and Miss Livingston,
co-authors of St. John Ambulance's new Home Nursing textbook "Patient
Care in the Home," which was released earlier this year, were honored
with the rank of Commander Sister by the Order of St. John.
Both nurses plan to remain with WHO
following their tour of duty in West Africa.
Home Care Topic for Institute
Dalhousie University's school of nursing
is sponsoring its 16th Annual Institute,
February 8-10, 1967.
The topic of the three-day workshop will
be Co-Ordinated Home Care Programs. Mrs.
Rosetta Lippe, assistant director of training
and extended services in home care with
New York's Montefiore Hospital, will be
the conference leader. She will be assisted
by members of the nursing and allied pro-
fessions in the Atlantic provinces.
The aim of this year's institute is to
enable all branches of nursing to fully un-
derstand Medicare's implications for home
care. It will be held at the Victoria Gen-
eral Hospital Nurses' Residence. Registration
fee is $2.00.
Medical Education
Research Unit Established
To find out what it takes to make a
good doctor, the University of Toronto has
established a medicaJ education research
unit - the first in North America.
The unit will include two medical doc-
tors, one of whom is a professor of psy-
chology and education, a data processing
expert, and a statistician. They will seek
answers to these questions:
What are the quaJities needed in a mo-
dern physician?
What types of education, both general
and specialized, will best prepare the doctor?
What personal qualities are most likely
to suit a student for the medical profes-
sion?
The research team does not expect to have
the answers for about 10 years.
Newfoundland Seminar
"One of the Best"
The recent two-day workshop sponsored
by the ARNN'S committees on nursing edu-
cation and nursing service has been termed
"one of the best."
It is the second workshop held this year
and according to ARNN President Janet
Story "enthusiasm and attendance exceeded
expectations." There
re over 226 regis-
trants at the St. John's workshop and 100
at the workshop in Gander.
The seminar had as its theme "Analyzing
Nursing Needs," with delegates discussing
such topics as future planning to improve
nursing care and team nursing.
Consultant to the workshop was Mrs.
Huguette Labelle, associate director of nurs-
ing education at the Ottawa General Hos-
pital. She addressed the delegates on the
responsibilities of every team leader and
emphasized the importance of such people
in assuring good patient care.
JANUARY 1%7
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Here's how smart Canadians are paying less
income tax and building a retirement income to
supplement their Canada Pension Plan.
WHAT'S AN ANNUITY?
A Canadian Government
Annuity is an investment
you make to guarantee
you a definite income
when your working days
are over. The premiums
you pay may be deduct-
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For instance, you can choose the Life Plan
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Or the Guaranteed Plan, also payable for
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Or the Contingent Suroit,or Plan which
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Your local Canadian
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Your Canadian Government Annuity is fully
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CANADA DEPARTMENT DF LABDUR. DTTAWA .
JANUARY 1%7
Perhaps you're already paying into a reg-
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If on termination of employment you are due
to receive a lump sum payment, you would
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that payment. But if you use the lump sum
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helpful Canadian Government Annuity
Representative near you, or fill in and mail
the coupon postage free.
THE CANADIAN NURSE 9
news
(Comil/lled fro", paRe 8)
Canadian Welfare Council Says
Action Needed to Increase
Health Manpower
The Canadian Welfare Council urges im-
mediate action to increase Canada's health
manpower and improve the di
tribution and
quality of personal health services during
the period before the Medical Care Act is
implemented.
This is the gisl of a resolution from the
Council's Board of Governors. addressed to
the federal government and circulated to
provincial premiers and minislers of health
and welfare.
Commenting on Ihe resolution, B. M.
Alexandor. Q.c.. president of the Council
said: "Like most members of parliament,
including those in the government. we very
much regret any postponement in the date
of implementation. Apart from other con-
siderations. the connection between poverty
and untreated ill health is all too obvious,
and adequate health care measures are es-
sential to any realistic attack on poverty.
ONE-STEP PREP
with
FLEET ENEMA:
single dose
disposable unit
FLEET ENEMA's fast prep time obsoletes soap and
water procedures. The enema does not require warm-
ing. It can be used at room temperature. It avoids the
ordeal of injecting large quantities of fluid into the
bowel, and the possibility of water intoxication.
The patient should preferably be lying on the left side
with the knees flexed, or in the knee-chest position.
Once the protective cap has been removed, and the
prelubricated anatomically correct rectal tube gently
inserted, simple manual pressure on the container
does the rest! Care should be taken to ensure that
the contents of the bowel are completely expelled. Left
:
.. colon catharsis is normally achieved in two to five
minutes, with little or no mucosal irritation, pain or
spasm. If a patient is dehydrated or debilitated,
hypertonic solutions such as FLEET ENEMA, must
be administered with caution. Repeated use at short
intervals is to be avoided. Do not administer to children
under six months of age unless directed by a physician.
And afterwards, no scrubbing, no sterilisation, no
preparation for re-use. The complete FLEET ENEMA
unit is simply discarded!
Every special plastic "squeeze-bottle" contains 4Y2
fl. oz. of precisely formulated solution, so that the
adult dose of 4 fl. oz. can be easily expelled. A patented
diaphragm prevents leakage and reverse flow, as well
as ensuring a comfortable rate of administration.
Each J 00 cc. of FLEET ENEMA contains:
Sodium biphosphate. . . . . .. .... 16 gm.
Sodium phosphate ................. 6 gm.
For our brochure: "The Enema: Indications and Techniques",
containing full information, write to: Professional Service
Department, Charles E. Frosst & Co., P.O. Box 247,
Monfreal 3, P.Q.
-...."
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10 THE CANADIAN NURSE
",.'Y
QUALITY PHARMACEUTICALS
t;.
6..Co.
MONTREAL CANADA
'OUNDED IN CANADA IN 1Øgg
Delay in improving health care is therefore
most unfortunate, and we sincerely hope
that il will be possible to advance the in-
troduction of medicare from July I. 1968.
We are also very concerned that prepara-
lions for implementation and this. of
course, means action by the provinces _
should not slow down in this interim
period. It is all to easy to relax once the
pressure of an urgent deadline is eased."
On the question of health manpower and
the dislribution and quality of services, Mr.
Alexandor pointed out Ihat although the
Medical Care Act provides the major mecha-
nism for payment for medical care, strong
concurrent action is needed on these other
points if the program is to be truly ef-
fective.
.The Royal Commission on Health Serv-
ices. while urging that initiation of a medi-
cal care program should not wait for an
increase in health service resources, never-
theless strongly recommended a crash pro-
gram to strengthen them", Mr. Alexandor
said. "The Commission particularly referred
to strengthening of health personnel, which
is the first step in improving distribution and
quality of services. We need to start now.
through every means, public and private."
Mr. Alexandor stated that the Council's
resolution was prepared by its recently es-
tablished Committee on the Health Aspects
of Welfare. under the chairmanship of Dr.
John E.F. Hastings of the University of
Toronto School of Hygiene.
Controversy Among Montreal's
English-Speaking Nurses
The English-speaking nurses of the Mon-
treal region have decided to undertake
collective bargaining to regulate their work-
ing conditions. Thi
change in attilUde
toward colleclIve bargaining is partly because
the Hospital Services Commission has tended
to equalize salaries and working conditions
throughout the province, and partly because
the Association of Registered Nurses of the
Province of Quebec has urged its members
to use this means.
At present two groups are competing to
represent English-speaking nurses. The En-
glish-speaking chapter of District 11 held
a meeting on December 5, 1966, at which
the members adopted a resolution urging
the nurses of the chapter to form an asso-
ciation to negotiate for working conditions.
About 1,200 nurses were present at this
meeting. During the following days, some
5,000 nurses from the chapter were asked to
vote in favor of the new Association and
to sign a registration card.
When this organizational procedure has
been completed, the new association, which
will most probably be called the United
Nurses of Montreal, will immediately seek
to become accredited as bargaining agent
with the Labour Relations Board.
(Continued on page /2)
JANUARY 1967
J
IN PLACE
NOW...
a DISPOSABLE CLOSURE
for external solutions
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AMSCO
NEW FROM
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whether flask is Hermetically Sealed-
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AND DISCARD AFTER USE
. DESIGNED FOR ALL PYREX 500, 1000,
1500, 2000 ml. SOLUTION FLASKS
. ASK YOUR AMSCO MAN FOR A
DEMONSTRATION - IN THE MEANTIME
WRITE FOR CATALOG MC-521
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AIR
CANADA
-BRAMPTON. ONTARIO
DURING STERILIZATION AFTER STERILIZATION
,)
BETTER TO START WITH...
BEST TO STAY WITH'
news
(Continued from page /0)
The chapter president, Miss Moyra Allen
told the press that the association will be
independent of the large unions and will
not resort to strike action.
The Act regulating professional nursing
in the Province of Quebe<:: stipulates in Ar-
ticle 17 that "Each local association may
negotiate. conclude and sign as agent.
collective contracts or agreements with any
category of employer."
On the other hand, a group of nurses
from the Jewish General Hospital. under
the leadership of Miss Ruth Arnold, have
already organized themselves, and have
formed another organization known as the
Metropolitan Association of Nurses. On
November 24, 1966, this association asked
for accreditation from the Labour Board
and has begun recruiting nurses in other
Montreal hospitals.
At a meeting on December 8, 1966, this
group declared that the chapter (through the
United Nurses of Montreal) could not nego-
tiate for nurses as a large number of its
members were nurses who held administra-
tive positions. Their lawyer. M. Marc La-
pointe, also maintained that only the Metro-
politan Association of Nurses could obtain
the necessary accreditation to represent the
nurses. According to Miss Arnold. the
THE QUEEN'S PRINTER
wishes to inform you that
he is the exclusive sales agent
in Canada for 19 International Organizations.
Two of our International Organizations work for you and
publish books intended for you.
. WHO
World Health Organization
. FAO
Food and Agriculture Organization
Two of our International Organizations are concerned mainly
with all aspects of the development of nations and human
beings.
. UN
United Nations Organization
. UNESCO
United Nations Educational, Scientific and Cultural
Organization
Would you like to know more about their work, their publica-
tions ?
Would you like to receive a catalogue of their reports on re-
search?
Write to:
THE QUEEN'S PRINTER,
Ottawa r Canada.
12 THE CANADIAN NURSE
district 11 Chapter should limit its actions
to problems of a professional nature.
It is premature to predict the outcome of
these associations. The provincial association,
the ANPQ. is not taking part in this debate;
it is strictly a matter between the English-
speaking chapter District 11 and the Metro-
politan Association of Nurses as autonomous
organizations.
Baccalaureate Awards in '681
Students aiming for baccalaureate degrees
in nursing may be eligible for Canadian
Nurses' Foundation awards if Parliament
approves a proposed change in the Founda-
tion's Letters Patent.
At the CNF annual general meeting held
Tuesday, December 6, 1966, at CNA House
in Ottawa, it was proposed that the Founda-
tion awards, formerly available only to
those enrolled in master's or doctoral degree
programs, be extended to cover those seek-
ing baccalaureate degrees.
A favorable vote carried the proposed
amendment to the CNF Letters Patent. Un-
anamously passed was a member's resolu-
tion that the awards' selection committee
give priority to students enrolled in master's
and doctoral courses.
Awards to baccalaureate students will not
be available during the 1967-68 term since
Parliamentary approval must be secured
before the proposal can be implemented.
Elected to serve on the new board during
1967 and 1968 were M. Jean Anderson.
Verna Huffman, Mrs. Eva T. McCutcheon
and Alma Reid, and five members of the
CNA Board of Directors: Dr. Katherine
MacLaggan, Mrs. Helen P. Glass, Phyllis J.
Lyttle, E. Louise Miner, and Janet Story.
These new board members will serve two-
year tenns as approved by constitutional
amendment at the general meeting in 1965.
Canadian Nurses at Expo 67
Schools of nursing across Canada are
cooperating with the Canadian Nurses' Asso-
ciation in providing the nursing personnel
necessary for its exhibit at Expo '67.
Twenty-one graduate nurses and 78 stu-
dent nurses. on a rotating basis, will staff
the ultra-modern "Nurses" Station for
Intensive Observation" in the Man and
his Health Pavilion.
Equipped with telemetering and recording
devices, television monitors and inter-com-
munication equipment, the station has been
specially designed to show Expo's millions
of visitors how nurses will be trained to
maintain continuous observation of patients'
respiration rate, pulse, electrocardiograph
pattern, and other parameters in providing
intensive care.
The graduate nurses will wear uniforms
specially designed for the occasion with pins
and caps of their respective schools. Student
nurses will be in the distinctive uniforms of
their schools. A roster of the participating
schools and hospitals will be on one wall of
the exhibit.
JANUARY 1967
news
New Immigrants Protected
Against Hospital Bills
Newly-landed Immigrants entering Ont-
ario without hospital insurance will in
future be able to obtain temporary pro-
lection from Blue Cross until their govern-
ment hospital insurance takes over.
Hospital insurance regulations in Ontario
:md most other Canadian provinces require
new applicants to wait approximately three
months before becoming eligible for bene-
fits. Until now. no alternative coverage has
been available during this interim period,
and the individual immigrant (or his sponsor)
ha
been exposed to the possibility of heavy
hospital bills.
The new "Landed Immigrant"' plan re-
cently announced by Ontario Blue Cross
an
wers this threat by taking care of any
hospital expenses up to a maximum of $30
a day, the average daily hospital charge in
Ontario. To obtain this coverage for a
maximum period of 90 days (or until
government hospital benefits become ef-
fective. whichever is sooner). the individual
immigrant will pay to Blue Cross one
premium of $ 14.94. The cost to a family,
consisting of husband. wife and unmarried
children up to age 21. will be $28.98. As
the "Landed Immigrant" coverage cannot be
continued beyond 90 days, it will still be ne-
cessary for an immigrant to apply for govern-
ment hospital insurance immediately upon
arrival here to avoid a gap in protection.
Although the 90-day hospital coverage is
at present available only to persons immi-
grating to Ontario, Blue Cross Plans in other
provinces have expressed interest in offering
imilar protection to their own immigrants.
Immunity Test
for German Measles
A test for detecting immunity to rubella.
commonly known as German measles, has
been developed by scientists of the U. S.
Public Health Service's National Institutes of
Health. The test, called hemagglutination-in-
hibition (H-I), was developed in the Division
of Biologics Standards' Laboratory of Viral
Immunology of which Dr. Meyer is chief.
The rubella H-I test employs the biolo-
gical principle of hemagglutination or red
blood cell clumping, used successfully in
tudies on influenza and other diseases. Dr.
Meyer and his co-workers found that special
preparations of rubella virus cause the red
blood cells of newly hatched chicks to
clump. When they added a sample of
blood from a person immune to German
measles, the antibodies in the immune blood
inhibited clumping. Thus. the inhibition of
agglutination demonstrates the presence of
antibody and immunity.
The new test is so simple and reliable
that a physician can determine within three
JANUARY 1967
Medical Care at Expo 67
About 30,000 to 42,000 persons will
require medical care during the six-month
International Exhibition in Montreal this
summer - and Expo 67 officials will
be ready for them.
Medical aid at Expo will be provided
in two main types of facility: first aid
stations and medical aid clinics. As well,
more than 1,500 personnel will be pre-
pared to administer emergency first aid
treatment on the spot.
Medical Aid Clinic
Four Medical
Aid clinics will
be set up, one
in each sector
- Mackay Pier,
lie Sainte-Hélè-
ne, La Ronde,
and TIe Notre-
Dame. Each of
these will be a
IO-bed hospital with facilities and staff
to care for patients for up to 24 hours.
if necessary.
Negotiations are in progress to have
the clinics serve as an extension facility
of four of the larger Montreal hospitals.
Patients requiring longer term hospitaliza-
tion or more intensive care than the lO-
bed facility can offer will be transferred
to one of the larger institutions.
Clinics will have two wards - one of
four beds, another of six - kitchen. re-
ception. treatment and service rooms.
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First Aid Posts
As well as the clinics, there will be
hours whether an expectant mother has anti-
bodies against the disease. It is also capable
of detecting immunity years after infection.
The major hazard of rubella virus lies
in the risk of its transmission to the fetus
during early pregnancy, resulting in such
defects as blindness. deafness. congenital
hean disease. and brain involvement result-
ing in mental retardation.
Since the new immunity test is so inexpen-
sive and easy to perform, it is expected to
become routinely available in hospitals.
health depanments. and other laboratories
within the near future.
leukemia and Mongolism
Investigated
A paper prepared by the National Cancer
Institute. National Institutes of Health.
Bethesda, Maryland, examines the effects
of maternal age and binh order on the risk
of mongolism and leukemia. Authors
Charles Stark and Nathan Mantel study
children born in Michigan during 1950-64.
They discovered a striking association
between maternal age and mongolism. but
two first aid posts in each sector. These
will be open from 9:00 a.m. to 1:00 a.m.
and will be staffed by St. John Ambu-
lance personnel.
Many of the pavilions and exhibit
areas are also planning first aid facilities.
These will work
closely with the
Expo-sponsor-
ed services.
Six ambulances
will be provided
for transpon of
patients on the
Expo grounds
and for taking
patients to city hospitals.
Forecasts
Expo officials are expecting about
270,000 people to visit the huge site
each day. Based on statistics from the
Brussels. New York, and cther major
exhibitions. about 380 people will require
treatment for first aid each day; I 15- ISO
will be referred to Medical Aid Clinics;
and about 8 to 20 will require hospitali-
zation. Facilities are expected to handle
this number with relative ease.
The most common disorders anticipated
to require medical care at Expo are:
minor cuts, falls. sprains, heat stroke,
hean attacks. food poisoning. drownings.
and maternity cases.
In addition, Expo has worked closely
with the Quebec Government Emergency
Measures Organization to prepare a dis-
aster plan for the area.
found that birth order did not independently
affect the ri
k of mongolism. On the other
hand, both maternal age and birth order
independently affected the risk of death
from leukemia.
Risk of death from leukemia decreased
with advancing birth order and increased
with advancing maternal age. Except for the
older maternal age groups, these trends for
leukemia are in contrast to the effects of
maternal age and binh order on death due
to all causes. This contrast suggests that
maternal age and binh order may be closely
associated with the etiological agents of
childhood leukemia.
Ontario Hospital Receives Grant
National Health and Welfare Minister
Allan J. MacEachen has announced that a
federal grant of $281,938 for the Leaming-
ton District Memorial Hospital has been
approved. The grant will assist construction
and renovation programs for the hospital.
A new addition will provide space for
80 active treatment beds and 14 chronic
care beds.
(Continued on page 14)
THE CANADIAN NURSE 13
news
(Continued from paRe 13)
Renovations will improve patients' rooms
in the existing building. They will also pro-
vide for improving and expanding the kit-
chen, x-ray depanment, laboratories, deliv-
ery and operating rooms.
The work is expected to be completed
next month.
Parents Enthusiastic
About Hearing-Test Program
A new program to detect hearing defects
in newborn children has been launched at
the Jewish General Hospital in Montreal.
Dr. David Halperin, otolaryngologist-in-
chief of the hospital. said the object of the
program is to develop normal speech in the
deaf child so that he may attend regular
school classes by the time he reaches school
age. "Until now, even though hearing loss
in children could be detected at an early
age, nothing could be done for them. This
hearing loss resulted in development of
speech defects," he said.
Three different, small, ponable machines,
which have recently become available, can
test hearing ability within days after birth.
This breakthrough makes it possible to in-
stitute the corrective program at the hos-
pital. When deafness is detected in a child
at binh, he can now be supplied with a
hearing aid by the time he is six months old.
Parents of newborn children at the Jewish
General Hospital have responded enthusias-
tically to the project. Upon admission to
hospital, the mother-to-be receives a bi-
lingual leaflet explaining the program.
The leaflet says that "the incidence of
hearing loss at birth is very small - one out
of a thousand newborns will have such a
problem. If this one in a thousand is de-
tected within the first few weeks after birth,
the development of speech defe.::ts will be
avoided by taking immediate and appro-
priate training and educational measures."
To test as many infants as possible, the
hospital's clinic for communication disorders
is working closely with its pediatric clinic
and with the Herzl Health Service Centre.
The cooperation of private pediatricians has
also been obtained.
The hearing testing program is twofold.
Under the supervision of the hospital's au-
diologist, Miss Sylvia Dubitsky, specially
trained volunteers conduct tests either in
the mother's room or in the nursery. After
repeated testing to confirm the findings,
any infant whose hearing is found to be
impaired is sent to the McGill Project for
Deaf Children for education and training.
The McGill Proje.::t is under the direction of
Facts about
Registered Nurses
in Canada
Source: Research Unit,
Canadian Nurses
Association, 1966
14 THE CANADIAN NURSE
age
Daniel Ling, fonnerly principal of the Oral
School for the Deaf and a leading authority
in his field. The Project is staffed by teach-
ers specially trained for the work.
The Royal Victoria and Queen Elizabeth
Hospitals are both setting up hearing test-
ing programs similar to that now in opera-
tion at the Jewish General Hospital.
"It is our ultimate aim to make it pos-
sible for every child with congenital hearing
defects to attend a regular school at school
entrance age," said Dr. Halperin. "There
is no need, with all the facilities available,
for any child to be isolated as a handicapped
individual."
Anti-Smoking Measures Continue
A Smoking Withdrawal Study Center has
opened in Toronto under the direction of
Dr. N. Delarue of the University of Toron-
to and Dr. G. W. O. Moss, Deputy Medical
Officer of Health for the City of Toronto.
This experimental center hopes to deve-
lop new approaches to assist adults to stop
smoking as well as to determine reasons for
the successes or failures observed.
One of the basic objectives of the Can-
adian Smoking and Health Program is to
encourage smokers to discontinue the habit.
Through health education it is also endea-
voring to dissuade non-smokers from acquir-
ing the habit.
35 - 44: 20.3 %
II
45 - 54: 15.0 %
g
55 and over:
10.5 %
.
Age not reported:
7.9%
&I
24 & under: 12.7 %
o 25 - 34: 33.7 %
JANUARY 1967
news
PMAC Head Urges Stronger
Patent Laws
The Pharmaceutical Manufacturers Asso-
ciation of Canada believes that stronger pat-
ent laws are needed to encourage pharmaceu-
tical production and research in Canada.
Association president, Dr. Wm. W. Wigle,
told the Commons Special Committee on
Drug Costs and Prices recently that patents
and the economic incentives they provide
are essential to the discovery and continuing
flow of health-restoring and life-saving phar-
maceuticals.
Stressing the dangers inherent in any sug-
gestion that drug costs could be lowered by
abolishing patents, Dr. Wigle said "from
a therapeutic point of view it would be a
medical catastrophe because research for
new cures would be seriously arrested." He
suggested that from an economic point of
view it would destroy a growing industry
and reduce it to nothing more than a collec-
tion of import houses and imitators.
PMAC's patent advisor, Gordon Hender-
son, Q. c., pointed out to the committee
that a patent not only encourages inven-
tion through research but constitutes an
incentive to production. "The abolition of
patents would lead to the Canadian market
becoming dependent upon foreign producers
with the risk that necessary drugs might be-
come unavailable in times of great need," he
said.
The association recommends that patent
protection for drugs be strengthened by per-
mitting patents on drug products rather than
just on manufacturing processes as at present.
Manitoba Doctors Want
Higher Pay
Manitoba doctors have threatened to with-
draw from the province's doctor-operated
medical insurance plan unless their demands
for higher remuneration are met.
The Manitoba Medical Service covers
about 600,000 of the province's 1,000,000
people. Doctors now receive payment on the
basis of 80 percent of their operating fee
schedule. They want 100 percent and threa-
ten to withdraw from the plan by July I,
1967, if they do not get it.
At a special meeting of the Manitoba Me-
dical Association, some 200 doctors endorsed
a resolution by president-elect, Dr. G. E.
Mosher, asking that MMS achieve full pay-
ment of the fee schedule by mid-1967.
According to Dr. Mosher, the pro-rating
principle was used when MMS was establi-
shed because it was needed to keep the ser-
vice solvent and the service was intended
for low-income subscribers. "We cannot
stand aside and idly watch economic factors
wear away our standards until we are giving,
and are receiving, assembly-line medicine."
Dr. Mosher said that if the MMS failed
JANUARY 1967
to comply with the resolution, he would
ask every doctor in Manitoba for a signed,
undated letter, opting out of the plan.
If the doctors' demand is met, it could
mean an increase in MMS subscriber fees of
between 20 and 25 percent.
Doctors say if !hey pull out of MMS,
their services will still be available to their
patient
- but on a direct basis.
U.S. Study Reveals Shortage
of Hospital Personnel
A new study of health manpower sup-
ply and needs in United States' hospitals
reveals significant shortages in all categories
of professional and technical personnel.
The U.S. Department of Health, Educa-
tion and Welfare announced recently that
comprehensive information on hospital man-
power is now available from a study made
jointly by the American Hospital Associa-
tion and the Public Health Service.
The study was made to determine the
number of personnel employed, current
vacancies, and estimates of personnel needs.
Data from the first 4,600 hospitals which
reported have been used to estimate totals
for all 7,100 hospitals in the United States
registered by the American Hospital Asso-
ciation. These reports indicate that the total
number of professional, technical, and auxi-
liary personnel employed in hospitals is
about 1.4 million. About 275,000 additional
professional and technical personnel would
In the Nightingale Tradition
I'
\
At a dinner party in Victoria, British
Columbia, 40 members of the Victo-
ria Unit of the Nursing Sisters' Asso-
ciation of Canada heard Mrs. G.
Stewart, who was dressed to repre-
sent Florence Nightingale, read an
address originally given by Miss
Nightingale to her students at St.
Thomas' Hospital, England, in 1881.
The theme of the evening was "Cen-
tennial," and many of those attend-
ing wore period costumes.
be needed to provide optimum patient care,
an increase of about 20 percent over present
staffing. Over 80,000 more professional
nurses and more than 40,000 practical
nurses are needed. Some 50,000 aides are
needed in general hospitals; another 30,000
in psychiatric institutions. Over 9,000 more
medical technologists, almost 7,000 social
workers, and about 4,000 more physical
therapists, x-ray technologists, and surgical
technicians are needed.
Most urgent needs are for nurses, practical
nurses, and aides. High on the urgent list,
too, are medical technologists, laboratory
assistants, radiologic technologists, dietitians,
physical therapists, occupational therapists,
and social workers.
Cmadian-Designed Device
Measures Hidden Skull Pressure J
A University of Saskatchewan biomedical
engineering student has developed a device
to measure intracranial pressure precisely.
The instrument, created by Gerald Wade,
was described at the Canadian Medical and
Biological Engineering Conference in Otta-
wa. It may permit diagnosis of such serious
conditions as hydrocephalus in infants be-
fore brain damage occurs.
A fluid-filled transducer is placed against
the fontanelle. The transducer feeds into
an electronic recording device that gives a
dial reading. The instrument makes 20 se-
parate determinations of the cerebrospinal
fluid and provides a visual readout of the
average fluid.
The device is presently being used as a
research instrument. Mr. Wade sees wide
potential use for it in routine screening of
newborn infants for the detection of ab-
normal intracranial pressures.
Two-Day Conference Set on
Rural Health
Rural-urban Health Relationships will be
the theme of the 20th National Conference
on Rural Health to be held March 10-11,
1967, at Charlotte, North Carolina.
The conference will explore new needs and
report on new developments in community
planning and responsibility for health fa-
cilities and services; future patterns of per-
sonal health care; rural accident prevention
and first aid instruction; and health man-
power - planning and utilizing.
There is no registration fee for the con-
ference, which will convene at 9:00 A.M..
Friday, March 10. Registration opens at
7:30 A.M.. March 10.
Cooperating organizations include Co-
operative Extension Services, Farm Organi-
zations, Medical Associations and Auxilia-
ries, Health Departments, Allied Health Or-
ganizations, Women's Groups, Agricultural
News Media, and Continuing Education
Groups.
Further details are available from the
Council on Rural Health, American Medical
Association, S3S North Dearborn Street,
Chicago, Illinois, 60610.
THE CANADIAN NURSE 1S
names
With "no intention
of reminiscing about
past efforts, past fai-
lures, missed opportu-
nities. small accom-
plishments," Dorothy
M. Percy retires. J an-
uary 6, 1967, as chief
nursing consultant for
the Department of
National Health and Welfare.
Her many friends. admirers and colleagues
who honored her at a testimonial dinner
last September did not share her concepts
of herself.
She was recognized by Katherine Mac-
Laggan, president of CNA, as "a woman
who is an advisor on nursing, a consultant
on nursing, a remarkable nurse, a pioneer,
a success in the eyes of her peers and a
recipient of love."
Miss Percy, born and educated in Ottawa,
began her nursing career in 1924 with her
graduation from the Toronto General Hos-
pital School of Nursing. The following
year she qualified in public health nursing at
the University of Toronto.
Before joining the Victorian Order of
Nurses in 1927, Miss Percy served as head
nurse in the medical ward of the Ottawa
Civic Hospital. It was while she was in
charge of publicity at national office that
Miss Percy organized the VON's first mari-
onette show at the Toronto Exhibition.
From 1934 to 1941 she was part of the
teaching faculty of the University of Toron-
to. Immediately following her teaching
career, Miss Percy enlisted with RMAC, and
after a year at the Camp Borden Military
Hospital. proceeded overseas to Canadian
General Hospitals in Great Britain. She re-
turned to Canada in 1944 and was appointed
matron at the Petawawa Military Hospital.
Following the war, Dorothy Percy served
as executive secretary of the Division of
Health of the Welfare Council of Toronto.
A year later. 1947. she was appointed to
head the new division of nursing under the
Department of National Health and Welfare.
In 1953, Miss Percy was appointed chief
nursing consultant to the Department of
National Health and Welfare, in which ca-
pacity "she has been called upon to inter-
pret government policy and suggest the ap-
propriate ways and means of attaining objec-
tives."
"
""':; ,
.
-
...
Plans for retirement? Miss Percy says, ".
can't answer that at the moment. I'm much
too busy getting down to the dreary chore
of cleaning out desk drawers and filing
cabinets!"
16 THE CANADIAN NURSE
Mildred Irene Wal-
ker, senior nursing
consultant in the occu-
pational health divi-
sion of the National
Health and Welfare
Department, retired
November 30. 1966.
Her busy and vari-
ed nursing career be-
gan in 1924 with her graduation from the
Victoria Hospital School of Nursing. Lon-
don. Ontario. The following year, Miss
Walker received her certificate in public
health nursing from the University of West-
ern Ontario.
Miss Walker's nursing career has been
largely administr.ative. Following a short
period of private duty nursing at Victoria
Hospital, London, Ontario. she became a
public health nurse in the town of Weston,
Ontario.
After two years she joined the staff of
the Ontario department of health where she
worked for three years. In 1930 Miss Walker
joined the faculty of the University of West-
ern Ontario as a lecturer. She later became
an assistant professor of nursing and served
as chief of the division of study for gradu-
ate nurses in the Institute of Public Health
at the University.
Upon completion of her advanced study
at Columbia University, New York. Miss
Walker accepted the position of supervising
nurse at Phillips Electrical Company, Brock-
ville. Ontario.
In 1949 Miss Walker became senior nurs-
ing consultant in the occupational health
division of the Department of National
Health and Welfare. Ottawa. In this posi-
tion she was responsible for developing the
present industrial nursing program.
On her retirement. November 30, 1966.
Miss Walker was looking forward to "the
first leisurely Christmas in years. and future
enjoyment of a summer cottage on the St.
Lawrence River."
"
...
A new member has
joined the editorial
staff of THE CANADIAN
NURSE. Carla Dianne
Penn, born in London.
England, received her
education in Canada.
She attended the Uni-
versity of Ottawa
where she recently re-
ceived her B.A. (English). Miss Penn as-
sumed the position of editorial assistant
in October. This is a new editorial position
created to help meet the journal's expand-
ing needs.
--.
-
Cathryn Lillian Mar-
tin, a native of Tex-
as, joined the staff of
McMaster University
School of Nursing in
Hamilton, Ontario.
this year. This is a first
Canadian position for
Miss Martin, who is a
graduate of the School
of Nursing of Tuskegee Institute, Alabama.
She also holds a B.Sc.N. from the Institute
and an M.A. in curriculum and teaching
maternal-child health from Columbia Uni-
versity. New York. In 1965 she obtained
her master of education with a major in
guidance.
Prior to her appointment as assistant profes-
sor of nursing at McMaster, Miss Martin
held positions in various hospitals and
schools of nursing in Texas, including her
most recent as assistant professor at the
Tuskegee Institute.
-
A. Joyce Bailey re-
cently assumed the po-
sition of assistant di-
rector of nursing ser-
vice at The Wellesley
Hospital, Toronto Ont-
ario, Miss Bailey, a
1956 graduate of The
I Wellesley Hospital
School of Nursing, re-
ceived her B.Sc.N. from the University of
Toronto in 1964. The following year she
was awarded the Canadian Nurses' Founda-
tion Scholarship and is presently completing
her thesis for Western Reserve University,
Cleveland, Ohio.
Prior to her present position as assistant
director of nursing service, Miss Bailey
worked at various levels on the staff of The
Wellesley Hospital, including general staff
nurse, assistant head nurse and head nurse.
Rita J. Lussier has
been appointed nurs-
ing coordinator at the
Expo '67 pavillion
__ "Man and His Health."
Miss Lussier gradu-
ated from the School
of Nursing of the Mai-
sonneuve Hospital and
later obtained nursing
experience in cardiac surgery at the Mon-
treal Children's Hospital. She received her
baccalaureate in nursing science from J'lnsti-
tut Marguerite d'Y ouville in 1962. During
the next three years, Miss Lussier taught at
the School of Nursing at the Maisonneuve
JANUARY 1967
names
Hospital, ,md in 1965 ....,IS named ,I'sistant
director of nursing service in charge of the
inservice teaching program.
Miss Lussier is on loan to Expo from the
Maisonneuve Hospital.
Lieutenant Colonel
Muriel E. Everett. ad-
ministrator of the
Salvation Army Grace
General Hospital. SI.
St. James. Manitoba.
recently received a fel-
lowship in the Amer-
ican College of Ho-.-
pital Administrators.
Lieul. Colonel Everett, a native of Perth,
Au
tralia. served with the Australian Forces
in the Far East as a nursing sister and held
various appointments in her homeland be-
fore moving to Canada in 1951. She has
held various positions in Canada. chiefly of
an administrative nature. and has been ad-
ministrator of the Grace General since I 96:!.
Another addition to
the McMaster Univer-
sity School of Nursing
staff is Gertrude Fran-
ces Burns. Miss Burns,
a graduate of the
Marymount School of
Nursing, Sudbury Gen-
eral Hospital, Sudbury,
Ontario, is a lecturer
in medical-surgical nursing.
After graduation Miss Burns worked as
staff nurse on medical and surgical nursing
wards at the Sudbury General Hospital. In
1964 she went to McGill University in
Momreal where she obtained a diploma in
supervision and teaching and her bachelor's
degree in nursing and nursing education.
Between her university sessions and until
her present appointment as lecturer, Miss
Burns worked at The Montreal General
Hospital.
..J.
-I
....
....
The new director of nursing at the Kirk-
land and District Hospital, Kirkland Lake.
Ontario is Annikki Huhtanen.
Miss Huhtanen. a 1940 graduate of the
School of Nursing in Viipuri, Finland,
served in the Finninsh Army nursing service
for four years following graduation. The
next four years she worked as a staff nurse
at the Central Military Hospital, Helsinki.
Miss Huhtanen moved to Canada in 1949.
and immediately began nursing at The
Montreal General Hospital. After four years
she moved to the Temiskaming Hospital.
Temiskaming, Quebec, and in 1955 she
moved again, this time to the Stevenson
Memorial Hospital, Alliston. Ontario.
In 1960 Miss Huhtanen returned to Fin-
land where she completed a course for di-
JANUARY 1967
rector
and administrators in the nur,ing
field. Upon her return to Canada, she be-
came director of nursing. as well as super-
visor-administrator at the Cottage Hospital.
Uxbridge. Ontario.
Now in Kirkland Lake, Miss Huhtanen
takes over supervisory dUlie
from Miss
Gertrude Koivll. who is no.... working to-
ward her nursing degree in Montreal.
The new director of nursing spent two
years in postgraduate study: one year in
cero-bacteriology and one year in laboratory
work in clinical hem otology.
Her new duties include the charge of the
nursing staff of 124 as well as responsibiiity
for the staff of the central supply service
and the operating room personnel.
Grace Elisabeth Ter-
ry, a 1963 graduate
of the Victoria Hospi-
tal. London, Ontario.
is a new lecturer in
nursing at Hamilton"s
.J J McMaster University.
The past three years
have been busy for
Miss Terry. In 1964 she received her
B.Sc.N. in nursing education from the Uni-
versity of Western Ontario in London;
throughout 1965 and 1966 she held positions
as part-time lecturer in nursing at McMaster,
general duty nurse at the Henderson Gen-
eral Hospital, Hamilton, and, finally, as-
sistant head nurse in the same hospital.
Margaret G. Arnstein, well-known to
Canadian nurses for her leadership in the
profession, has retired from the U.S. Public
Health Service to accept a professorship
with the School of Public Health at the
University of Michigan.
As nurse director in the Service's Com-
missioned Corps, Miss Arnstein had been
heading a nursing unit to serve health pro-
grams of the Agency for International
Development, with special emphasis on the
nurse and midwife role in the new programs
of population control and nutrition. Her
previous assignment was to the Rockefeller
Foundation AID-Study of the preparation
of health manpower in developing countries.
From 1949 to 1964, Miss Arnstein direct-
ed programs that promoted the effective
utilization and expansion of nursing service
skills in all the States, that stimulated and
supported the advancement of research in
nursing, and that influenced the improve-
ment and growth of nursing education. She
was instrumental in the development of both
the U.S. Nurse Training Act of 1964 and
the earlier legislation providing Federal
traineeships to enable nurses to receive the
educational preparation necessary for leader-
ship positions.
A graduate of the Presbyterian Hospital
School of Nursing, New York, Miss Arn-
stein earned her baccalaureate degree at
.
..
\
FOR WOMEN ONLY
. . . LAXATIVE NEWS!
"When I think of the suffering I could
have avoided if I'd known about COR-
RECTOL" sooner! A friend recommended
it and we've found it fine for every age
group from Grandma to ten-year-old
daughter." - Mrs. E.H.
CORRECTOL has been 'Specially developed
for a woman's delicate system. Its secret
is a non-laxative regulatar that simply
softens waste. And, CORRECTOL contains
just enough mild laxative to give regu-
larity a start. Working together, these
two gentle ingredients in CORRECTOL
give a woman effective relief, even fol-
lowing childbirth.
CORRECTOL
.reg'd. T.M., Pharmaco (Canada) Ltd.
COLOR SLIDE PROGRAMS
ON: COLOSTOMY
AND ILEOSTOMY
P. O. MANAGEMENT
Contoin anatomicol diagrams and phOfos
demonstrating fhe step-by-step procedures
for properly coring for the patient posf-
operafively. Complete with outhoritotive
commentary on the Professionol and nurse-
potienf level.
r----------------------
TO: UNITEO SURGICAL SUPPLIES CO., INC.
154 Midland Ave.,Port Chester,N.V .,U.S.A.
pleose send me your FREE
descriptive literature :# 738 C.N.
NAME:
ADDRESS,
CITY,
STATE,
ZIP,
L._______J
UMÆDSURG
ALSUP
SCO.WC
PQRf CHESTER NEW VOR
THE CANADIAN NURSE 17
POSEY BELT No. 4157
This Posey Belt may be used on a patient in
a chair or bed. When used on a patient in a
chair, it is slipped over the patient's head with
the 51 iding section of the belt in the front of
the patient. The long strap goes in back of the
patient; the ends are taken back of the chair
and hooked together. When this Posey Belt is
usen on a patient in bed, it is sl ipped over the
patient's head with the long strap at the pa-
tient's back. Tl,e snaps on the belt are hooked
to a strap with a liD" ring which has been
attached to the spring rail of the bed_ Made of
2" heavy webbing. May be laundered. Avail.
able in small, medium and large sizes. No.
4157. $9.90 ea.
., (') 0
. . .
THE POSEY MITT
To limit patient's hand activity. An adjustable
strap attached to the mitt and the side rail ot
the spring determine limit of movement. Can
be laundered by ordinary methods. Comforta-
ble, and prevents patient's scratching, pulling
out catheter, nasal tube, etc. Available Small,
Medium and Large. No. C-212-(both sides
flexible) $6.30 each - $12.60 per pair. No.
R-212-(palm side rigid) $6.60 each-$13.20
per pair.
,
'i
'. -
. $''''
, - .
.'i1 ( .t -
" .' 4"
...",
ð'"r
...
........
".
WRIST OR ANKLE RESTRAINT
A friendly restraint available in infant, small,
medium and large sizes. Alsi widely used for
holding extremity during intravenous injection
No. P-450, $6.00 per pair, $12.00 per set. With
DECUBITUS padding, No. P.450A, $7.00 per
pair, $14.00 per set.
POSEY PRODUCTS
Stocked in Canada
B. C. HOLLINGSHEAD LIMITED
64 Gerrard Street, E.
Toronto 2, Canada
18 THE CANADIAN NURSE
names
(C01lt;I/I/Cc/ from pagc /7)
Smith College, her master of arts in public
health nursing from Columbia University,
and her master of public health from the
Johns Hopkins School of Hygiene and
Public Health. She holds honorary degrees
of doctor of science from Smith College and
Wayne State University.
Arlene Elizabeth Aish, Catherine Shirley
MacLeod, Hazel Lillian Salmon, Sally Jane
Miller, and Judith Anne Ritchie have re-
cently joined the teaching staff of the School
of Nursing, University of New Brunswick
in Fredericton.
Arlene Aish, a 1958 graduate of the SchOûI
of Nursing, University of British Colum-
bia, worked as staff nurse at the Vancouver
General Hospital and as public health nurse
with the Toronto Department of Health
before continuing her studies. In 1961 she
obtained her master of nursing from the
University of Washington, Seattle, and
worked for the next four years as a lecturer
at the University of Toronto School of
Nursing. Miss Aish is presently an assistant
professor at the School of Nursing, Uni-
versity of New Brunswick.
Shirley Macleod, a native of Denmark,
Nova Scotia, received her training at the
l'"foncton Hospital School of Nursing in
1949. The following year she completed an
obstetrical clinical course at the Margaret
Hague Maternity Hospital in Jersey City.
N.J. The next seven years Miss MacLeod
spent as obstetrical supervisor at the Monc-
ton Hospital. Before taking up her new ap-
pointment as lecturer at the University of
New Brunswick School of Nursing, Miss
MacLeod received her baccalaureate degree
from McGill University and was obstetrical
clinical instructor at the Moncton Hospital
School of Nursing.
..
Hazel Salmon, a 1946 graduale of The
Montreal General Hospital School of
Nursing, has covered much territory in her
nursing career. After receiving a certificate
in public health nursing from McGill Uni-
versity, Miss Salmon spent three years as
taff nurse with the New Brunswick Depart-
ment of Health. From 1952 to 1955 she
erved with the Victorian Order of Nurses
in Woodstock, New Brunswick. Miss Salmon
Ihen headed north to work with the Indian
and Northern Health Services in White-
horse, Yukon, for two years as public
he ,11th nurse and then went west to the
Calgary area for two years in the same
capacity. In 1962 she obtained her bachelor
of nursing from Dalhousie University, N.S..
and in 1964 her master of (applied) science
from McGill. Prior to her present appoint-
ment as lecturer at the School of Nursing.
University of New Brunswick, Miss Salmon
was supervisor of nursing with the Temis-
kaming Health Unit, Kirkland Lake, Onto
Sally Jane Miller, from Edmundston, New
Brunswick, graduated from the School of
Nursing, University of New Brunswick in
1964. Following graduation, she worked as
general duty nurse at the Hotel-Dieu de
Saint-Joseph in Edmundston. Her new po-
sition is clinical instructor at the University
of New Bnmswick School of Nursing.
Judith Ritchie is another new clinical in-
structor at the U.N.B. School of Nursing.
Miss Ritchie obtained her B.N. from the
University of New Brunswick in 1965 and
spent the following year as general duty
nurse at the Montreal Children's Hospital.
Margaret Harrison, Norma Jaenen, Edythe
Huffman, Marie Knelsen, and Jessie Hibbert
were recently appointed to the School of
Nursing Faculty at the Calgary General
Hospital. Returning to the Faculty after
completion of studies are Coralea Toney,
Elaine Parfitt, Barbara Dobbie and Judy Ban-
natyne.
Mrs. Harrison, a graduate in nursing
science at the University of British Co-
lumbia, is leaching surgical nursing.
Mrs. Jaenen, an instructor in orthopedic
nursing, obtained her B.Sc.N. from the Uni-
versity of Saskatchewan.
l'"frs. Huffman, a former graduate of the
School of Nursing. Calgary General Hos-
pital, served as senior health nurse in the
Flin Flon, l'"fanitoba Health Unit, and also
worked with the Winnipeg Health De p.! rt-
ment prior to her new position. She is pre-
sently instructor in obstetrical nursing.
Mrs. Knelsen, another graduate of the
School of Nursing, Calgary General Hospi-
tal, obtained a diploma in public health
nursing from the University of l'"faniloba.
She is assistant instructor in nursing arls and
also teaches pharmacology.
Mrs. Hibbert, a new instructor in psychi-
atric nursing, graduated from the Winnipeg
General Hospital School of Nursing. She
later attended the San Francisco State Col-
lege where she earned her B.A. in nursing
and her M.A. in education. At UCLA Mrs.
Hibbert obtained her Master's in psychiatric
nursing.
l'"fiss Toney, a graduate of the Winnipeg
General Hospital School of Nursing, has re-
turned to the Calgary General Hospital
School of Nursing after completing her
bachelor of nursing degree at McGill. She
is instructor in gynecology.
Mrs. Parfitt. who recently compleled her
B.Sc.N. at Ihe University of Alberta is teach-
ing growth and development. ophthamology,
and urology.
Miss Dobbie, an instructor in pediatric
nursing, obtained her bachelor of nursing
degree from McGill University in Montreal.
Mrs. Bannatyne, an instructor in medical
nursing, recently earned her bachelor of
science in nursing degree from the Uni-
versity of Alberta.
JANUARY 1967
names
An Honorary Life Membership in the
Nova Scotia Branch of The Canadian Public
Health Association was awarded recently to
Edna Pitts who retired from public health
nursing in 1964.
The award was made in recognition of
her "diligent and conscientious approach to
nursing care" and for her many years of
devoted service to public health nursing
in Nova Scotia.
Miss Pitts' busy nursing career began
with her graduation from St. Mary's Hos-
pital, Brooklyn, New York. A course in
public health nursing at Columbia Univer-
sity prepared her for the position of public
health nurse with the Provincial Depart-
ment of Health in Cape Breton, where she
worked for two years. In 1939 she was
transferred to the staff of Lunenburg-
Queens-Shelburne Division and, in 1955, to
the Atlantic Health Unit, a position she
held until her retirement in 1964.
Miss Pitts wiII long be remembered for
her "family centered" approach to nursing
and for her keen interest in the affairs of
the community in which she worked.
Anita Germaine has been appointed director
:>f nursing service at the Scarborough Cen-
enary Hospital, West HiII, Ontario.
Miss Gennaine is a graduate of the Gen-
ral Hospital School of Nursing. Pembroke,
Ontario. Her experience includes nursing
iervice, nursing education, and employment
in various levels of management in a large
ransportation industry.
On her return from England in 1960,
,he was assistant dean and consultant for
an air career school, primarily interested in
procedure, manuals and methods of per-
ionnel training for various transportation
agencies in Canada and Africa.
Miss Gennaine joined the staff of Scar-
borough General Hospital in 1963 as an
instructor in the registered nurse assistant
school, and from 1964 to 1966 was asso-
::iate director of nursing service, coordinator
of staff development and education pro-
grams, and responsible for management de-
velopment training within the hospital.
Dianne J. Hoffinger and Alma M. Daisley
were both awarded $1,000 bursaries from
the Saskatchewan Registered Nurses' Asso-
.:JÌation.
Miss Hoffinger, a native of Regina, Sas-
katchewan, is presently completing her
nursing degree at the University of Al-
berta in Edmonton.
Miss Daisley, a 1963 graduate of the Sas-
katoon City Hospital School of Nursing, is
presently in her final year of the nursing
program at the University of Western On-
tario, London.
The SRNA bursary fund was established
JANUARY 1967
in 1964 10 provide financial assistance for
registered nurses in postgraduate studies or
in the final years of baccalaureate programs.
The fund is financed from interest received
from association investments and from dona-
tions and endowments.
The 1966 winner of the ARNN bursary
is Donna Le Drew. The $150 bursary, offered
by the Gander Chapter of the Association
of Registered Nurses of Newfoundland, is
to be offered annually to a student in the
Gander area who has been accepted at one
of the schools of nursing. Miss Le Drew
commenced her nursing education at the
General Hospital, St. John's, this October.
Louise Dupuis, in her final year at the Uni-
versity of Ottawa School of Nursing, and
Verna Jardine, at the University of New
Brunswick School of Nursing, were both
awarded the Muriel Archibald Scholarship.
Valued at $500, this scholarship is presented
by the New Brunswick Association of Regis-
tered Nurses.
Carolyn Wilson and Annette Frenette have
been awarded NBARN scholarships of $500
each. Miss Wilson is presently attending the
University of New Brunswick School of
Nursing while Miss Frenette is continuing
her studies at the University of Moncton
School of Nursing.
Ethel R, Irwin has been appointed senior
consultant in public health nursing in the
Local Health Services Branch, Toronto. For
two years prior to taking up her new duties,
Miss Irwin was regional consultant in public
health nursing, London, Ontario.
A graduate of the Toronto General Hos-
pital School of Nursing, Miss Irwin obtained
her certificate in administration and super-
vision from the University of Toronto
School of Nursing. In 1954 she joined the
Temiskaming Health Unit and in 1956 was
appointed regional supervisor in Northern
Ontario.
Mis Irwin returned to her studies in 1957
as a student at Teachers' College, Columbia
University. She obtained her Bachelor of
Science degree in 1961.
Dr, Philip Banister has been appointed doc-
tor at the Child and Maternal Health Divi-
sion of the Department of Health and
National Welfare. A specialist on pediatrics,
Dr. Banister will help to complete the pub-
lication on standards of hospital care for
mothers and their newborn infants. He will
also be active in preparing the first national
conference on maternal and infant hygiene,
which will take place next year in Ottawa.
Born in England, Dr. Banister received
his medical degree from Edinbourgh Uni-
versity, Scotland. He specialized in pediatrics
at the Montreal Children's Hospital as well
as in the United States and Italy. D
'-J--"
R
Namt Poo rJ
Preferred by Nurses Everywhere! J #
. i
: No.
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ANN COHN, loP. N.
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M\SS "EM) NURSE
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No.
100
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No.
169
Largesl selling among nurses I Superb lifelime qua-
lity . .. smoolh rounded edges... fealherweighl,
lies flal. . . deeply engraved, and lacquered. Snow-
white plastic will not yellow. Satisfaction guaran-
leed. GROUP DISCOUNTS. " write for full color
order envelopes, group prices.
SMART IDEA: Order 2 idonlical (samo name) Pins
at dilcount price., at precaution qoin.t 10.. and
added convenience
(I..s changing).
With 1 line Wit" 2 lines
lellerml lelleflnl
1 Pin ani, .60 .90
2 Idenllell 1.00 1.60
1 Pin onl, 1.25 1.55
2 Identlc
1 2.00 2.60
R
' t: aC g
ap. lè
-
Now remove and retas.
ten cap band instanlly
for launder in I or
replacement! Delicately
melded Cap. Toes are in.
conspicuOUs front and
back, yet sturdy far
years of service.
Choose Black. Dk. Blue or Clear
plastic with tmy gold caduceus
mot,f. __ or Sohd Black (no gOld)
6
::'.$ 1
Inl,
TO, RUYE$ COMPA"Y, AtlleÞoro. Mass. 02703
STYLE DESIRED, No. o. .hown obove.
METAL FINISH (169 or 100) Gold 0 Silver 0
LETTERING COLOR, Block 0 Dark Blue 0
Please send 0 1 Pin
o 2 PinS (same name)
LETTERING,
2nd Line;
......-------------
Please send :J 1 Pin 0 2 Pins (same name)
LETTERING:
2nd Line:
--------------
Please send 0 I Pin
o 2 Pins (same name)
LETTER I NG,
2nd Line,
Pleo.e .end .eh Cop. Ton (6 per .el)
::J Block C Ok. Blue 0 Cleor LJ Solid Block
I enclole S
(Mon. re.idenh add 3% S.T.1
Send 10
Slreel
Cily Slole Zip
NOTE: Order for 1. '2 or 3 persons on above
coupon. . . U5e extra sheet for more.
"Dilleren'" fdeas for Gills and f;lvors. Too!
THE CANADIAN NURSE 19
{
A New Text!
Kallins
TEXTBOOI< OF
PUBLIC HEALTH NURSING
Here is an effective new approach to public health
nursing. stressing usable facts and principles of
public health rather than theory. Designed for courses
in Public Health Nursing, this new text integrates
essential principles of the science of public health with
the major areas of nursing knowledge and practice.
Precise, readily understood discussions give students
clear, effective guidelines and principles upon which
to base their nursing diagnosis and intervention
for the protection of health as well as prevention of
disease and disability. You will find up-to-the-minute
evaluations of current solutions to such new
public health problems as mental health, drug
addiction, alcoholism, air pollution control, poison
and radiation control, housing and slum situations,
rehabilitation, control of heart disease and cancer,
as well as nursing education. TEXTBOOK OF
PUBLIC HEALTH NURSING sheds new light on
the growing dimension of this specialized area of
nursing practice and gives the student nurse a
thorough understanding of her potential role in the
various public health areas. You will appreciate the
flexible design of this new text, and its adaptability to
your individual classroom situation.
By ETHEL L. KALLINS, R.N., B.S., M.P.H., Assistant Professor
of Public Health and Public Health Nursing, St. Joseph College,
Division of Nursing, Emmitsburg, Maryland. Publication date:
January, 1967. Approx. 375 pages, 6Yz" x 9Yz", 57 illustrations.
About $8.10.
20 THE CANADIAN NURSE
1
we ·
lf6" fPttJ'
wid a ð4
tIteVt
tie fUVU
New 2nd Edition!
Heckel-Jordan
PSYCHOLOGY
The Nurse and the Patient
The new 2nd edition of this stimulating textbc
has been revised and updated to give the nurs,
a working knowledge of psychology so that sl
in turn, can deal more effectively with the mar
of patients she encounters. This text can hell
students clearly see the importance of psychol
in achieving satisfactory nurse-patient relation
Designed for basic courses in psychology in b(
diploma and degree programs in Schools of
Professional Nursing, this new 2nd edition ha
carefully revised to provide a completely curn
in-depth presentation of general psychology æ
relates to the field of nursing. Extremely read
easy to understand, this new edition can help 1
student relate psychological principles to her (
experiences as a student, as a nurse and as a p
This edition examines its subject in greater de
than the previous edition and includes all tht
views and concepts. An entirely new chapter
on sensation can provide your students with a
understanding of this subject.
By ROBERT V. HECKEL, B.S., M.S., Ph.D., Professor of F
Director of Clinical Training, and Director of the Psycho"
Services Center, University of Soutt: Carolina, Columb
and ROSE M. JORDAN, B.S., R.N., Supervision of In-Sen
Education, Gracewood State School and Hospital, Gracey,
Publication date: January, 1967. 2nd edition, approx. 36
6Yz" x 9Yz", 88 illustrations. Price, $8.10.
JANUARY 1967
texú tð Iedp
11t
d
þt
New Book!
;h- Wagner
JRI<BOOI< FOR
NECOlOGIC NURSING
ynecologic disorders, many underlying
hological factors are more disturbing to
>atient than the fact her physical health is
ted. This new workbook assists the
nt nurse in becoming aware of this
donal involvement and in learning how
, explanation is within the scope of
ing care. Giving close attention to both
heory and clinical experiences involved in
cologic nursing. the authors specifically
s the equal importance of student
vledge of reproductive anatomy and
iology, and their awareness of the
'nt's emotional involvement.
eeding from the basic to the clinical,
workbook explains the anatomy and
iology of the female reproductive organs,
describes puberty, the gynecologic
lination and the nurse in the clinic,
"ders of menstruation, functional and
unctional bleeding. and the menopause.
mg its timely discussions are those
acterizing genital anomalies, gynecologic
lems in marriage, pelvic inflammatory
ise. and neoplasms of the uterus
ovaries.
flexible design of this workbook makes it
ly suited for use with any required text
select. Perforated, punched pages
v removal of completed assignments for
ing and accumulation in a ring binder
uture reference. Self-examination tests
ncluded and a separate, 20 page answer
is provided for the instructor.
)NSTANCE lERCH, R.N., B.S., (Ed.); and JOANNE
GNER, R.N., B.S. (Nurs.). Publication date:
'ry, 1967. Approx. 130 pages, 7 1 "" x 10%",
rated, perforated and punched. About $3.80.
New 7th Edition!
Jessee
SELF-TEACHING TESTS
IN ARITHMETIC FOR NURSES
Here is a simple, direct approach to basic arithmetic
and its application to problems in dosages and solutions.
Flexibly designed for use as either a self-teaching text
or for classroom instruction, this book can help your
student develop sufficient knowledge and skill in arithmetic
so that she can learn to safely administer medications
in the proper dosage. To bring it into closer conformity
with modern mathematics, this new edition has been
rewritten and expanded to incorporate new information
and changes in terminology.
This new edition has been designed with perforated,
punched pages that can be easily removed from the text,
handed in and/or kept in a separate book or folder.
The achievement tests have been printed on separate pages
so that, if desired, you can use them in evaluating the
progress of your students. You will also appreciate
the convenience of the separate answer book, provided
with each copy at no additional cost.
By RUTH W. JESSEE, R.N., Ed.D., Chairman, Department of Nursing
Education, Wilkes College, Wilkes-Barre, Pennsylvania. Publication date:
March, 1967. 7th edition, approx. 164 pages, 7 1 "" x 10%",
21 illustrations. About $3.25.
New 4th Edition!
Price
A HANDBOOI< AND CHARTING
MANUAL FOR STUDENT NURSES
This unique handbook is ideally suited to (1) help the
student applicant prepare herself to meet scholastic
requirements for admission to schools of nursing and
(2) to assist the beginning student who experiences
difficulty with one or more of the courses she is taking.
It is used as a self help handbook or as a required test.
This book can help you give your students the additional
help they may need in arithmetic, spelling, vocabulary,
study habits and reading with comprehension, handwriting
and printing, and personal appearance. An important
feature of this workbook is the well written and highly
understandable presentation of the fundamentals of
charting. This section has been revised and updated
in this edition to give the student the latest accepted
methods and concepts of charting.
By ALICE l. PRICE, R.N., M.A. Publication date: January, 1967.
4th edition, approx. 220 pages, 8%" x 11", 50 illustrations.
About $5.30.
HE C. V. MOSBY COMPANY, LTD.
Publishers
86 Northline Road. Toronto 16, Ontario
JANUARY 1967
THE CANADIAN NURSE 21
new products
{
Descriptions are based on information
supplied by the manufacturer and are
provided only as a service to readers.
Benoxyl Lotion
(WINLEY-MORRIS)
Description - A locally effective agent for
the treatment of acne. Benoxyl lotion is a
stable preparation of Benzoyl Peroxide 5%
in a unique, greaseless, washable lotion base.
Indications - In the treatment of acne
vulgaris as an antibacterial and mild kera-
tolytic agent.
Administration - Cleanse skin with a mild
soap such as Acne-Aid detergent soap. Ap-
ply Benoxyl Lotion to affected areas with
fingertips and smooth in gently according
to the following schedule: first 4 days:
apply once daily, leave on for 2 hours, then
remove with warm water; next 4 days: apply
once daily, leave on for 4 hours, then re-
move; next three days: leave on overnight:
ultimately: apply after each washing.
Benoxyl is completely invisible on the
skin. It should be stored in a cool dark
place but not frozen.
Caution - Benoxyl is for external use
only and should be kept away from eyes,
mucous membranes and sensitive areas of
the neck. Should excessive drying or irrita-
tion occur, use should be discontinued tem-
porarily.
Disposable Toothbrush
(VENDEX)
Description - An entirely new disposable
toothbrush with its own buh-in dentifrice.
Developed by Du Pont, this nylon bristle
brush. to be distributed exclusively through
vending machines, is intended to fill a
erious gap in the dental hygiene routine of
people who find themselves away from
home without their regular toothbrush or
toothpaste.
Bristles are coated with a water-soluble
dentifrice which is activated when moistened
to perform the normal cleansing and breath-
sweetening functions of ordinary dentifrices.
Each brush is individually packaged in a
cellophane wrapper and is so economical it
may be thrown away after a single use.
Vendex International, Inc., Houston,
Texas, which has exclusive marketing rights
on the new product, will distribute the
brushes only through compact coin-operated
vending machines located in selected wash-
rooms of clubs, restaurants, airports, mo-
tels . .. "wherever there are active people
on the move." Vendex distributors are being
established in each market to serve as local
distributors for the handling of inventory
and servicing of the machines.
For additional information contact: Ro-
bert Fogle, vice president, Vendex Interna-
tional, Inc., 4125 Richmond Avenue, Hous-
ton, Texas.
22 THE CANADIAN NURSE
Infant Vascular Clamp
(SKLAR)
Use - A new vascular clamp designed
by Dr. G.A. Trusler of the University of
Toronto. The new design has proven parti-
cularly useful in Blalock anastomisis, in the
repair of infant coarctations, and in other
procedures involving small vessels in chil-
dren and infants.
Description
The shaft is thin
and springy, thus,
when fully closed,
the clamp will
neither slip nor in-
jure the vessel. The
"Z" shape of the
jaws facilitates
placing and tying
of sutures. The op-
posing jaws of the
clamp are relatively
flat, with a finely
roughened surface which provides a secure
grip, but will not split the soft intimal lining
of the vessel.
Descriptive literature (No. 280-190) is
available from J. Sklar Mfg. Co. Inc., 38-04
Woodside Avenue. Long Island City. N.Y.
11I01.
alv
TR1 UR INr
T VA. I.i.R ClAMP
6 Pak Sutures
(THOMPSON)
Description - Six non-absorbable sutures
in one p.!cket in a quick-opening "book."
This package of sterile, non-traumatic silk
utures is convenient when a number of
uture
are needed quickly by the surgeon.
The six sutures, with attached needles, are
threaded on a paper "book" having con-
venient end flaps. The folded book is sealed
and irradiation sterilized in a transparent
peelable outer envelope. The nurse or as-
sistant merely pulls the end flaps to open
the book and the sutures are ready for
instant use.
R. H. Thompson Laboratories Ltd., an
all-Canadian firm, developed this new "6
Pak." Further information may be obtained
by writing the Laboratorie
in Don Mills.
Ontario.
Acne Aid Cream
(WINLEY-MORRIS)
Description - A flesh-colored. greaseles
agent with water-washable base for the treat-
ment of acne. Acne-Aid cream is composed
of 2.5% sulfur, 1.25% resorcinol. .625%
hexachlorophene and .375% para meta
chloroxylenol.
Indications - In acne vulgaris, and where
a mild keratolytic, anti-seborrheic and anti-
microbial agent is required.
Administration - Wash the affected part
with whatever special cleanser is recom-
mended by the doctor. Dry thoroughly
without rubbing. Apply Acne-Aid Cream
with the fingertips. allowing a thin film to
remain.
Caution - Keep away from eyes and off
eyelids. Should excessive dryness or irrita-
tion develop, discontinue use temporarily.
Uroscreen Test
(PFIZER)
Description - A simple, convenient. rapid
and reliable screening test. standardized for
the detection of significant bacteriuria
(100.000 or more organi
ms per ml. of
urine) Uroscreen i
a white. dry, stable,
soluble. buffered tetrazolium reagent (2, 3.
5 triphenyl tetrazolium chloride).
Indications - The presence of significant
bacteriuria is indicated by the formation of
a pink to red precipitate - indicating a pos-
itive uroscreen test. No precipitate or a
colorless precipitate shows a negative uro-
screen test.
Procedure I. Collect urille: e3rly
morning specimen is preferable. Collect the
"midstream" specimen from men and the
"clean-catch" specimen from women. If the
test cannot be performed within 2 hour
after collection, the specimen
hould be
stored, below 10 0 C. up to 24 hours before
uroscreen testing. 2. Add to um.Kreen: Shake
urine specimen until any precipitate is
uniformly suspended. Add 2ml. of urine to
the uroscreen tube, which is marked at the
2 ml. level. Shake well until the uroscreen
reagent is completely dissolved. 3. Incubate:
Incubate at 37 0 C for 4 hours in the Uro-
screen dry-bath incubato- or other suitable
type. rmportant: do not shake or disturb the
uroscreen tube during incubation. If the
precipitate is disturbed before the reading,
the resuspended precipitate mu
t be centri-
fuged or the test repeated. 4. Read re.llllt.\: A
positive uro<;creen test (pink to red precipi-
tate) is indicative of the presence of
ignifi-
cant bacteriuria and calls for detailed bac-
teriological examination of the urine. Highly
infected urines may give a red precipitate
within I or 2 hours imd also show a red
turbidity throughout the urine. A pink to
red color, without precipitate. is negative;
a precipitate of any other color is also
negative.
Uro
creen is pre
ented in boxes of 50
te
t tubes. ready to use. A special dry-bath
incubator is available free of charge with
initial orders of 100 tubes or more.
For further information on Uroscreen and
urinary tract infections, contact Pfizer Com-
pany Ltd., 50, Place Cremazie, Montreal II.
JANUARY 1%7
dates
]
January 9-11, 1967
Second Educational Assembly on
Hospital Administration, District Eight,
Fort Garry Hotel, Winnipeg.
January 11-13 and January 16-18, 1967
Institute for Supervisors, Ramada Inn,
Vancouver, B.C.
Open to all nurses working as
supervisors or to head nurses who
assume supervisory functions.
Details may be obtained from the
Registered Nurses' Association of B.C.
January 24-26, 1967
Institute on Outpatient Department
Nursing Service Management,
Bellevue Stratford Hospital,
Philadelphia, Penna.
February 6-9, 1967
Four-day conference on staff education
and staff development. Sponsored by
RNAO, OHA, OMA, OPHA, OHSC,
Westbury Hotel, Toronto.
February 19-23
14th Annual Association of
Operating Room Nurses' Congress.
EI Cortez and U.S. Grant Hotels
San Diego, California.
For information write 151 East 50th
St., New York City or Miss Nellie
Mock, 458 "F" St., Chula Vista,
California.
End of March
Institutes for Instructors, Ramada Inn,
Vancouver, B.C.
A two-day institute sponsored by the
Registered Nurses' Association of B.C.
April 28 - October 27, 1967
Expo '67, Montreal.
May 4-6, 1967
St. Boniface Hospital, School of
Nursing, 25th Reunion of the 1942
graduating class. Would members of
the 1942 graduating class please
write to Miss F.E. Taylor, R.N.,
10123 - 122 Street, Edmonton.
May 8-12, 1967
National league for Nursing, Biennial
Convention, New York.
May 10-12, 1967
Canadian Hospital Association,
Montreal, P.Q.
May 16-19, 1967
Alberta Association of Registered
Nurses Annual Meeting, Chateau
lacombe, Edmonton, Alberta.
JANUARY 1967
May 24-26, 1967
International symposium on electrical
activity of the heart, london, Ontario.
For further information, write to
Dr. G.W. Manning, Victoria Hospital,
london, Onto
May 31 - June 2, 1967
Registered Nurses' Association of
Nova Scotia Annual Meeting, Sydney,
N. S.
May 31 - June 2, 1967
Registered Nurses' Association of
British Columbia Annual Meeting,
Bayshore Inn, Vancouver, B.C.
June 12-15, 1967
Canadian Dietetic Association 32nd
Convention, Château laurier, Ottawa.
June 18-21, 1967
Ottawa Civic Hospital, Centennial
Home Coming.
Alumnae or former associates of the
Ottawa Civic Hospital who are
interested in the Program should write
to: Executive Director, Ottawa Civic
Hospital.
June 24, 1967
St. Joseph's Hospital, Toronto, School
of Nursing, Centennial Reunion.
Any graduates who do not receive
alumnae newsletters, please send
name and address to: St. Joseph's
Hospital, School of Nursing Alumnae,
30 The Queensway, Toronto 3,
Ontario.
July, 1967
75th Anniversary, Nova Scotia
Hospital School of Nursing, Dartmouth,
N.S.
All interested graduates please
contact Mrs. G. Varheff, 20 Ellenvale
Ave., Dartmouth, N.S.
July 31 - August 4, 1967
The annual Medical Equipment
Display and Conference (Medac '67).
Sponsored by the Association for the
advancement of medical instrumenta-
tion (AAMI), San Francisco Hilton
Hotel. For information write:
AAMI, P.O. Box 314, Harvard Square,
Cambridge, Massachusetts 02138.
Sept. 15-17, 1967
70th Anniversary, Aberdeen Hospital
School of Nursing, New Glasgow,
Nova Scotia. Those interested write:
Mrs. Allison MacCulioch, R.R. #2,
New Glasgow, Pictou Co.,
Nova Scotia.
MOVING
?
.
DON'T FORGET YOUR
CHANGE OF ADDRESS
Name:
Registration No.:
(If registered in two provinces.
please give both.)
Province:
Old Address:
New Address:
Date effective:
Allow at least six weeks
for change of address
Mail to:
The Canadian Nurse
50 the Driveway
Ottawa 4, Onto
THE CANADIAN NURSE 23
No one ever said it would be easy.
running a hospital with a minimum of profit. Unless you count it profitable to see
medical supplies - building a bridge with developing nations master new skills and
nothing but timber and sweat - teaching a new standards of health and science.
child who knows only a strange tongue. But You can't earn a promotion. . . but you can
that's what CUSO workers do . . . hundreds promote. You will promote new learning, and
of them in 35 countries. They meet the chal- enthusiasm, and a desire to succeed in
lenge of a world of inequalities - in educa- people who are eager to help themselves.
tion, in technical facilities, in engineering There are no Christmas bonuses. . . but you
and medicine. earn a bonus every day in the response of
This year, the Canadian University Service the people you work and live with. And you'll
Overseas - a non-profit non-government be amazed at how quickly you'll find an op-
organization - has already sent 350 young portunity to develop your ideas, your dreams.
volunteers to countries in Asia, in Africa, Willing to work to build a better world?
South America and the Caribbean. . a .. Here's just the job for you.
total of 550 CUSO people altogether in A.
-: How do you apply? Get more informa-
the field, or about 1 to every 50,000 . . .;' tion and application forms from local
people who ask for their help. More. CUSO representatives at any Canadian
are needed. university, or from the Executive Sec-
The pay is low. . . you won't make a retary of CUSO. 151 Slater St., Ottawa.
cuso
The Canadian Peace Corps
24 THE CANADIAN NURSE
JANUARY 1967
"Wallted - a revised Itlcome Tax Act
that recognizes the role of married
women in the labor force."
This is what over one million work-
ing women - and their husbands -
will yearn for when they compile their
annual income tax forms early in 1967.
For the present income tax structure
is geared to a Victorian society where
only the man of the family was employ-
ed and the woman stayed home as a
dependent.
Husband no longer sole breadwinner
According to 1965 data from the
Special Surveys Division, Dominion
Bureau of Statistics, the number of
working women in this country is now
over 2 million. This represents 30
rcent of the total work force.
Prior to 1960, single women out-
ranked married women in the labor
force. Since 1960, however, married
women have maintained first rank in
the percentage distribution by marital
status. Their percentage passed the
half-way mark in 1964. and now stands
at 52.2.
That these married women play an
essential role in our economy is un-
deniable. That the large number of
married women who are presently un-
employed would be valuable recruits
to the labor force is also undeniable.
except by those few who still maintain
that the woman's place belongs only
at the hearth.
Needed changes in tax structure
The major changes that are needed
to bring income tax regulations up-to-
date with the manpower structure in
Canada were brought to the attention
of the House of Commons this past
June, by Mrs. Grace MacInnis, Mem-
ber of Parliament for Vancouver-
Kingsway, B.c.
Mrs. MacInnis said that the amount
a married woman is allowed to earn
before deductions are made from her
husband's taxable income ($250), is
far too low. considering today's cost
of living. She pointed out that various
organizations across the country have
JANUARY 1967
EDITORIAL
requested that it be raised. The Can-
adian Federation of University Women,
for example, have urged that the
amount be increased to $950.
The second change in taxation
policy proposed by Mrs. MacInnis, in-
volved the expenses of housekeeping
and babysitting services. She recom-
mended that the wages of housekeepers
should be deductible from the taxable
incomes of mothers working outside
the home. In defence of her proposal
she said:
"It is no use telling us that .it is
all very well for lawyers and business-
men to deduct necessary expenses, but
that it is quite another matter for a
woman working outside the home to
ask for the right to make the same
sort of deductions. The expenditure is
just as necessary. In fact, it is more
necessary because it has been esta-
blished . .. that the vast majority of
women who go to work. . . do so from
economic necessity, and there is no
question of their being able to meet
the costs of a housekeeper from out-
side earnings."
In an earlier speech in the House of
Commons, Mrs. MacInnis questioned
the incongruity of a law that calls a
working woman who employs a house-
keeper an "employer" - and requires
her to contribute to the housekeeper's
Canada Pension Plan - yet refuses to
call her an employer under the Income
Tax Act, thereby disallowing any de-
ductions of housekeeper expenses.
Taxation in other countries
In certain countries, such as the
United States of America and the
United Kingdom, the tax position for
married women is quite favorable.
In the United States, for example, a
working wife can deduct up to $900
for child care expenses when there are
two or more children, or $600 for one
child. The stipulations are that the
child be no more than 12 years old,
and that the joint income of the parents
not exceed $6,000.
In the United Kingdom, preference
is given to working married women:
they get a single person's tax-free al-
lowance for earnings, in addition to
t
e husband benefiting from the mar-
ned man's allowance, which is nearly
double the single person's.*
The tax structures in a few coun-
tries, on the other hand, appear to be
intended to discourage the wives of
all but the neediest of husbands from
employment. In the Netherlands, for
example, a married woman's earnings
are taxed 15 percent if she is not the
breadwinner. **
Nurses effected
What effect does this out-dated IIl-
come tax act have on nurses?
For single nurses, it has little effect
at this time; however, a few years from
now many of these nurses will have
assumed the role of wife, and possibly,
mother. If the present trend toward
employment continues - and there is
every reason to believe it will - they
will be among those affected by these
discriminatory tax policies.
For married nurses, who represent
60 percent of all nurses employed full-
time, these tax policies must be frus-
trating, costly, and discouraging. That
these nurses continue to work in spite
of them is proof of their desire to
remain active in the profession.
For the 19,781 married nurses listed
as "not employed in nursing" in 1965,
the present income tax policies un-
doubtedly discourage re-employment.
The return of even a portion of these
women to active nursing would do
much to offset the critical shortage of
nurses throughout the country.
Conclusion
For those married nurses already
working, and for those who represent
a large, untapped source of manpower.
revisions of the Income Tax Act would
mean one less obstacle in the path to
employment.
If we speak loudly enough, in
unison, Canada will listen.
* Viola Klein. Women Workers - Working
Hours and Services. Paris. Organization for
Economic Co-operation and Development.
1965.
** Ibid.
THE CANADIAN NURSE 25
Habilitation of thalidomide
children: the nursing approach
Most of the children suffering from
congenital deformities as a result of
thalidomide were hospitalized during
their first year of life. At this stage,
the nurse's role was largely custodial.
The nursing problems of these chil-
dren - skin care, sitting balance, and
protection from injury - differed from
those of normal children.
As the children started to grow,
however, the nurse had to re-examine
her role. How could the basic concept
of rehabilitation - the return of the
patient to a meaningful role in society
- be applied to these children who
had little or no idea of the outside
world?
Several of these children were still
hospitalized at two years of age. The
difference in development between
them and the children who had the
advantages of normal home life was
apparent. It was pinpointed by the
work of our colleagues in psychology.
whose findings made it eviòent that
something had to be done to provide
the hospitalized children with some
of the advantagcs and stimulation of
a domestic environment.
The first problem involved the num-
ber of persons coming in contact with
the children. A stuòy by the hospital's
social service department showed that
each child had a minimum of 43 con-
tacts each day: nurses, doctors, thera-
pists, volunteers, nonprofessional staff,
patients, and visitors. Further, because
of the rotation system, the nurses car-
ing for the children changed two or
26 THE CANADIAN NURSE
How do thalidomide children react to the outside world after a prolonged
hospitalization and what type of help do they need to adjust to it? A team at the
Rehabilitation Institute of Montreal attempted to answer these questions.
Mary O'Brien, R.N., Margaret Owens, R.N., and 'an Ralph, R.N.
three times each week.
Several steps were taken to solve
these problems. First, a "baby-team,"
consisting of two registered nurses and
one licensed nursing assistant, was set
up. The team leader was a nurse with
pediatric training and a great deal of
experience. The second R.N. was the
mother of a two-year-old. The nursing
assistant was a young married woman
who had shown special aptitude in
caring for children. Two nursing as-
sistants were assigned especially for
evening duty.
This team. under the supervision of
the head nurse, took over the complete
care of the children. The arrangement
demanded some sacrifice from the
other staff in the unit. Since the babv
team did not rotate, the other staff
had to do more tours on shift duty;
also, those not assigned to care for the
children regretted the loss of contact
with a most lovable group of patients.
However, after an explanation by the
director of nursing. they accepted these
arrangements. Similarly, the volunteers
cheerfully agreed to confine their at-
tentions to the older children.
The head nurse then re-examined
the phvsical setup of the ward. In-
stead of occupying six small rooms -
four for sleeping, one for eating, and
Miss O'Brien was director of nur
ing at
the Rehabilitation Institute of Montreal.
Mi
s Owen
i
head nurse on the pediatric
unit, amI Mi
Ralph i
the team leader
of the "baby team" formed at the rn
titute.
one for playing - the children took
over two large units - one for sleep-
ing, the other for eating and playing.
This had many advantages: 1. The
children seemed more secure and less
confined within a larger, definite area.
They were out of the way of other
patients, wheelchairs and corridor traf-
fic; 2. The rooms (23 feet x 17 1/2
feet) were near the nursing station, so
that observation was constant; 3. Bet-
ter cross-ventilation was possible and
it was easier to maintain a constant
room temperature; 4. The children's
toys and equipment were more ade-
quately controlled and were safe from
the raids of older children.
At this point, the baby team dis-
carded their uniforms in favor of street
clothing. This proved very successful.
The children were encouraged to call
the baby team nurses by their Christian
names. There were two reasons for
this. The children's speech develop-
ment was slow and it did not seem
reasonable to expect a child whose
first words would normally be "mama"
or "papa", to substitute "Miss Ralph"
or "Madame RousseL" Further, at two
to three years of age, the children were
not identifying individuals. As they
were mostly French-speaking, everyone
was "ma tante." By using Christian
names, the children found it easier to
identify the nurses, and their "aunts"
became special rather than general.
The next step was to introduce the
children to the outside world. Outings
were initiated at such times as they
JANUARY 1967
.}
JANUARY 1967
_.
The clothing requirements of children
with deformities are complex. The staff
at the Rehabilitation Institute of
Montreal developed several functional
garments for the children with
prostheses, including the dress and
panties shown in photograph.
.
"
.
\
could be coordinated with prosthetic
training. Small groups were taken to
visit the zoo, the circus, shopping cen-
ters, Santa Claus, and to eat lunch
in a restaurant. They had picnics and
train rides and were taken skating in
a public park. When the children were
from three-and-one-half to four-years-
old, our physiotherapy department
began teaching them to swim; their
daily sessions in the pool are now a
high spot.
The baby team nurses also took the
children to their own homes for lunch.
On these visits the children appreciated
seeing things they did not see in the
Institute: design and - color of food;
china and tablecloths; shower curtains;
door knobs, and carpets. We have tried
to introduce as many of these as pos-
sible to the Institute.
The result of these outings was ex-
tremely satisfying. The most with-
drawn child became quite relaxed
about new human contacts. The reac-
tion of the general public was also
encouraging. Apart from an occasional
stare and a few questions from mothers
with children of the same age, we met
only kindly interest and offers of help.
From the outings the children de-
veloped interest in dressing and wear-
ing pretty clothes. We made no attempt
to hide prostheses, but tried to dress
the children as much as possible like
children their own age. They now
have very definite likes and dislikes in
color, and we have tried to make them
feel that the garments they prefer are
THE CANADIAN NURSE 27
r
1
The hospitalized children now occupy
two large units - one for sleeping,
the other for eating and playing.
Daily swimming sessions in the pool
are a high spot for the children.
......
- .............. _ rII--
----
their own and not communal.
The clothing requirements of chil-
dren with deformities are complex. As
so many people are involved, the baby
team leader has been given the addi-
tional assignment of coordinating the
needs and ideas of occupational thera-
pist, parents, nurses and volunteers.
Much thought was given to the de-
sign of garments to be worn over pros-
theses, especially those of the upper
extremities. After consultation with
nurses, occupational therapists, psy-
chologists, and a group of ladies who
kindly offered to sew for us, we have
evolved several functional garments
that are also attractive. Velcro clos-
ures have been used instead of but-
tons, but the illusion has been pre-
served by sewing buttons in place.
Since we found that the action of
cables quickly wore through materials,
we have used iron-on patches inside
shirts and in dresses across the shoul-
ders. The velcro can be opened and
closed with the prosthesis or feet, thus
making the child as independent as
possible in dressing and undressing.
One attractive but useful dress has
velcro closures down the back. It is
sleeveless with separate sleeves (in a
white or contrasting color) which can
be attached with velcro inside around
the armhole. For most activities the
child can use the prosthesis without
sleeves; for dress-up occasions the
sleeves are easily attached.
Toilet independence has presented
many problems because of the chil-
28 THE CANADIAN NURSE
I
,
)-
.
\
.
-
'"-----
-
,
..
,
-
"
-
.,
-
dren's prostheses and lack of upper
extremities. Panties have been designed
on a diaper principle, with strips of
velcro down each side substituting for
safety pins. The diaper is held around
the waist by an attached band of ma-
terial. To remove the flap of the pan-
ties for toilet purposes, the front flap
can be pulled down with the child's
prosthesis or fingers inserted in a loop
made of tape on either upper front
corner of the diaper . To replace the
flap of the panties, the child sits down
on the diaper and raises the flap using
the loops to pull it up into position.
Then he stands up and presses his hips
against the wall to fasten the velcro
securely. One of our mothers devised
a method of pulling panties up and
down with tapes and attaching them
with velcro, but this method still re-
quires further thought and develop-
ment.
It is interesting to note how the
concept of the "rehabilitation team" is
applied to the thalidomide group of
children. Every week the baby team
has held a meeting led by the con-
sultant in psychology. Her advice on
the management of individual children
and general problems has been inval-
uable. Since the nurse and occupational
therapist must work together in pros-
thetic training, the occupational thera-
pist in charge of the children also at-
tended these meetings. From the meet-
ings a most rewarding relationship
with social service developed, which
has since expanded beyond this group
-
òii;:
of children to all age groups in the
unit. Our colleagues in speech therapy
who attended these meetings outlined
the normal development of speech and
pointed out specific difficulties with
various children. The department of
therapeutic recreation helped us with
outings. Volunteers have been very
valuable. In fact, the whole operation
has been a real team effort, under
the benign supervision of the chief of
service.
Now the children are all in their
own homes or foster homes. We hope
that we have made their adjustment a
little easier. Certainly congenitally mal-
formed children who come to us in
future will pre.sent fewer problems to
the nursing department in the light
of this unique experience. D
JANUARY 1967
Impact of cerebral palsy on
patient and family
What must parents face when told
that their child has cerebral palsy?
They must face the fact that the con-
dition cannot be cured by medical or
surgical procedures and that the effects
of the disease will persist throughout
the life of the individual. They must
realize that the disease may limit
education and employability, marriage
and the bearing of children, self-
sufficiency, and self -support. Although
these limitations are modifiable through
therapy, the parents will have to invest
a considerable amount of time and
money in the therapeutic program.
This program will change the normal
routines of the home and will, of
necessity, create an extremely close
relationship between the parents and
their handicapped child.
Some parents will have to face the
fact that their child has additional de-
fects, such as mental retardation, deaf-
ness, aphasia, and convulsions, with
all their inherent problems.
The impact of the diagnosis on the
family is tremendous, and the inter-
view during which the parents are
confronted with this diagnosis is ex-
tremely traumatic.
Problems unique to cerebral palsy
The diagnosis of cerebral palsy is
usually made after months of anxiety.
Frequently, the parents have been dis-
turbed by a number of different and
conflicting diagnoses including, in most
cases, that of mental retardation. This
delay is less frequent in recent years,
JANUARY 1967
Feelings of inferiority on the part of the patient, jealousy on the part of the
siblings, and guilt on the part of parents, are common reactions to this disease.
William A. Hawke, M.D., F,R.C.P. (Lond.) , F.R.C.P. (C)
however, since physicians are becom-
ing more skilled in diagnosing cerebral
palsy in young children, and are be-
coming more cautious in diagnosing
mental retardation.
The parents of cerebral palsied
children affect each other both indi-
vidually and in groups. These relation-
ships are usually beneficial. Parents
provide each other with additional
information about the disease and
about techniques that they have found
to be effective. In many instances they
support each other. On occasion,
however, the effects may not be so
satisfactory. Some parents make others,
who plan to place their severely handi-
capped children in institutions, feel
that they are inadequate parents who
are shirking their responsibilities. Oc-
casionally, certain parents may make
it difficult for other parents to accept
the reality of the situation, the limita-
tions of therapy, and the ultimate
future. These effects, however, seem
to be less frequent at the present time,
probably because families have a
closer relationship with treatment cen-
ters, particularly with social workers
in these centers.
The staff of the treatment centers
may create problems for the parents.
Occasionally they give a poor prog-
nosis, which is unwarranted. More
Dr. Hawke is Professor of Pediatrics,
University of Toronto, and Director of the
Neurological and Psychiatric Services of
The Hospital for Sick Children. Toronto.
frequently, however, they create opti-
mism in the parents because of an un-
justifiably euphoric prognosis.
There are several reasons for this
over optimism. First, staff members are
sympathetic to the parents and do not
wish to make them face unpleasant
realities. Second, certain members of
the staff may lack experience and
have not followed the progress of such
children for sufficient time to learn
the natural course of the disease. In
most cases, however, the staff and fam-
ily become involved in a personal
struggle against the disease, and in
this struggle the staff member loses
his or her objectivity. Fortunately,
these effects are less prominent at pres-
ent because most clinics now have
conferences in which the child's his-
tory is presented to the staff for dis-
cussion.
These are only a few of the prob-
lems that may be considered specific
to cerebral palsy. They are, however,
the most frequently occurring prob-
lems.
Effect on parents
Feelings of anxiety may develop in
the parents, particularly if the disease
is severe and the prognosis grave. In
one extreme case of anxiety reported
several years ago, two elderly per-
sons killed their only son who had
cerebral palsy, since they felt that they
no longer could give him adequate
care. They killed him rather than let
him go to an institution where they
THE CANADIAN NURSE 29
believed he would be given inadequate
and impersonal care.
A feeling of anger is also a com-
mon reaction of parents. In most
cases the anger is originally directed
against fate. "Why did this have to
happen to me and my child?" It is
seldom directed against the child, but
is projected on other individuals.
Parents may project this free-floating
anger toward the physician, blaming
him because they believe the disease
was due to improper delivery or to
inadequate care during pregnancy be-
cause the condition was originally mis-
diagnosed. They may project this
anger toward the physician because he
is unable to cure the disease. This
hostility is sometimes directed against
neighbors, or even strangers on the
street. Curiosity on the part of such
individuals may be considered by the
parents as evidence that they regard
the child as a freak.
Feelings of guilt frequently are
evidenced by parents. If there has been
a similar condition in the family, they
feel responsible for transmission of the
disease. They may feel responsible
for the child's cerebral palsy for a
number of reasons: Mothers who have
not followed the prescribed regimen
during pregnancy may believe that
their negligence is responsible for the
condition. In a certain number of
cases, the pregnancy was unwanted,
and the mothers carried out a number
of simple activities, such as long walks,
hot and cold baths, etc., in the hope
that these would produce an abortion.
If the child is born with a defect, the
parents feel that these attempts at
abortion have been responsible for the
defect. Other parents of a handicapped
child may feel that this has been their
punishment for past misdemeanors,
often sexual in nature.
Feelings of denial may be part of
the parents' pattern of defence. It is
very difficult for parents to deny the
cerebral palsy, but many deny the
prognosis, accepting the realities of the
present disability, but not ')f the future.
These parents frequently travel from
clinic to clinic, hoping to find someone
who will justify their opinions.
30 THE CANADIAN NURSE
Feelings of rejection may occur be-
cause of the unusual appearance of the
child, because of the additional burden
imposed on the family, and, in some
cases, because the individual is unable
to accept the fact that a child of his
can be incomplete or inadequate. Open
and frank rejection of the child is
uncommon. Such feelings are usually
intolerable to the parents and are re-
placed by feelings of oversolicitude and
overprotection.
Not all overprotection is a compen-
sation for rejection. It may simply be
the reaction of very affectionate
parents who feel sorry for their
handicapped child. An extreme exam-
ple of overprotection was the mother
of the epileptic child who would not
allow her daughter to cross the road
for fear that she might have a seizure.
This mother went to school with the
child, returned with her, and stood
at the window in her home during the
rest of the day to see that she was
not on the road. The mother of a 14-
year-old diabetic boy who had noc-
turnal reactions, slept with him so
that she could detect any reactions
that developed.
Effect on siblings
Usually the brothers and sisters of
the cerebral palsied child feel pity for
him, particularly if he is younger. They
feel sorry for him because his activities
are so restricted and because he can-
not join other children of his age in
various games and sports.
With time, however, these feelings
of pity often change. Jealousy may
develop because of the amount of
attention given by the parents to the
handicapped child. In some homes the
normal children are almost neglected,
and the parents focus their attention
on the handicapped child. Jealousy is
particularly marked if the sibling is
close in age to that of the handicapped
child, and also if he is of the same sex.
Feelings of guilt may arise in the
sibling. In many cases these develop
because he becomes disturbed about
his feelings of jealousy. He feels it is
wrong, almost "sinful," to have such
feelings about the brother or sister
who is so handicapped and whose life
is so limited.
If the parents are able to accept the
child, so will the siblings. Large fa-
milies seem to be able to accept the
handicapped child better than small
families. Rural families appear able to
accept them more adequately than
urban families. This sensitivity seems
to come to a peak during adolescence
and early adult life. It is particularly
evident in girls who think of marriage
and who are concerned about the im-
pact of the handicapped child on their
future husbands. A number are also
concerned about the possibility of
having similarly handicaped children
of their own.
Effect on handicapped individual
As the child grows older, the effects
of his handicap increase and are most
marked in adolescence and early adult
life.
The cerebral palsied child may de-
velop feelings of inadequacy or inferi-
ority because of his inability to take
part in normal activities, because of
his physical appearance, or because of
the limitations imposed on him by the
treatment of the disease. In addition,
he may experience a sense of isolation.
This, to some degree, depends upon
his inherited personality, but also upon
his opportunities for contact with other
children. Some children remain socially
and emotionally immature because of
restricted experiences and restricted
contacts with normal children.
Anger may be directed against the
limitations imposed by the disease, or
may be projected on others. It is often
projected on the normal siblings be-
cause they have a life that is richer
and fuller. Occasionally this hostility
may be projected against the mother,
whom the child blames for the disease.
Feelings of anxiety and insecurity
are particularly evident in older child-
ren who are handicapped. These feel-
ings are well-demonstrated by a girl
who developed poliomyelitis in ado-
lescence. She was a bright, intelligent
girl who had previously enjoyed nor-
mal activities. The poliomyelitis was
severe, and in the early weeks created
JANUARY 1967
.llmost total immobilization. In hos-
pital, she became depressed and was
referred for psychiatric assistance. It
soon became obvious that she was
concerned about her future, feeling
that she could never support herself,
would never marry, and would never
w
W
.
I
r
am
t
future had been destroyed by the
poliomyelitis.
It is obvious that the problems will
be intensified if the individual is intel-
lectually retarded. It is perhaps less
obvious that they wiII be intensified
if the individual shows specific patterns
of behavior calIed "the organic brain
syndrome." The behavioral patterns
noted in this syndrome include marked
distractibility, an inability to control
behavior, and an inability to work
consistently toward an organized goal.
There may also be distortions of audi-
tory perception that lead to problems
in understanding and producing speech,
or distortions of visual perception that
may lead to problems in reading and
writing. D
""".
"
-
.,
, .
r
""
....
.,
.....,.... .{ .
- '--
--,"".
-
"'
..
-",
.... ,
-
-
-
JANUARY 1967
THE CANADIAN NURSE 31
.
In
heart
Recent advances
surgery
In its early stages, surgery of the
heart was limited to the correction of
simple congenital lesions. Today open
heart surgery is capable of correcting
the more complex forms of congenital
and acquired heart diseases, and this
is true even in a far advanced stage of
the illness.
At the Montreal Heart Institute,
surgical procedures have been per-
formed since 1958. As has happened
elsewhere, there has been a geometric
progression in the number of cases per-
formed each year and in the steady
improvement of the results. In the
seven-year period from 1958 to 1965,
815 patients underwent intra-cardiac
operations using extracorporeal circu-
lation. During the first 4 years, 315
such procedures were performed as
compared to 500 in the last 3 years.
The early operative mortality was 35
to 40 percent, and it has decreased
progressively during the last period to
less than 10 percent. This occurred in
spite of surgical corrections of more
complex lesions on poor risk patients.
For instance, during the summer of
1965, three patients considered mori-
bunds successfully underwent emergen-
cy surgical com.ction of multi-valvular
lesions.
Extracorporeal circulation
Improvements in the
echniques of
cardio-pulmonary by-pass have opened
a completely new area in cardiovas-
cular surgery. To work under direct
32 THE CANADIAN NURSE
Today, scientific discoveries are integrated with increasing speed to the field of
practical application. Heart surgery was born in this age of spdce exploration and
gigantic scientific achievements. It has rapidly reached the stage of a
well-established science.
Pierre Grondin, M.D., and Claude Meere, M.D.
vIsIon inside the cardiac chambers, all
venous blood returning to the heart
must be drained off and returned un-
der pressure in the arterial system. The
heart-lung apparatus contains three es-
sential parts: a pumping system to as-
sure circulation of the blood, an arti-
ficial lung to oxygenate the blood, and
a heat exchanger to diminish oxygen
requirements of the tissues by lowering
the body temperature.
In cases where the ascending aorta
has to be clamped, like in aortic valve
replacement, an additional system is
needed to provide each coronary artery
with oxygenated blood and thus main-
tain viability of the cardiac muscle.
To collect the venous blood, a can-
nula is placed in each vena cava via
the right atrium. The blood is drained
into the oxygenator either by gravity or
by suction. In the oxygenator, oxygen
is brought in contact with the blood to
increase its available oxygen content.
The oxygenated fluid then goes into the
heat exchanger where cooling or warm-
ing is performed. (Fìgure 1.)
To avoid injury of the blood ele-
ments (red cells, leucocytes, etc.) the
pumps must be as atraumatic as pos-
sible. The blood is returned to the
body via a cannula which is inserted
either in the ascending aorta, or in a
femoral or an iliac artery. To keep the
Drs. Grondin and Meere are members of
the Department of Experimental Surgery at
the Montreal Heart Institute.
operative field bloodless, a cannula is,
in most instances, inserted for decom-
pression in the left ventricle through
the apex.
Intracardiac operations can be per-
formed by different incisions using a
right or a left thoracotomy. For several
years, however, a median sternotomy
has been commonly utilized, thus
avoiding opening of the pleura. By this
sternal approach, we are able to cor-
rect a considerable number of cardiac
lesions since all the heart valves and
most of the cardiac chambers are thus
easily accessible.
To avoid clotting of the blood in the
extracorporeal circuit, heparin is given
intravenously before cannulation of
the heart and blood vessels. We use
three mg. of heparin per kilogram of
body weight. When the intracardiac
operation is finished, the heparin is
neutralized by administration of an
equal amount of protamine.
In the cardiac surgery, air embo-
lisms must be carefully avoided, be-
cause the presence of gas bubbles in
small arteries acts as a clot causing
occlusion. Air emboli in small but im-
portant cerebral arteries are often fol-
lowed by serious neurological deficits.
Air embolism is prevented first by
adding filters to the heart-lung appa-
ratus and also by careful evacuation of
air from the heart chambers before
returning to normal cardiac function.
Hypothermia is a valuable aid in
extracorporeal circulation. Today,
JANUARY 1967
Fig. 1
EXTRACORPOREAL CIRCULATION
OXYGENATOR
I
j
,.1
DISC
BUBBLE
SCREENS
MEMBRANE
only moderate hypothermia is com-
monly used. It consists of a gradual de-
crease of the central body temperature
from 37 degrees to 29 or 30 degrees
(centigrade). At this level, oxygen re-
quirements of the tissues are decreased
by 50 percent.
Many delicate intracardiac proce-
dures are best performed on a "quiet"
or arrested heart. Cardiac contractions
can be stopped by several means. One
of them consists of inducing a deep and
selective cardiac hypothermia. These
low temperatures produce cardiac ar-
rest and/or ventricular fibrillation.
More recently, we have preferred the
use of a small electrical current which
induces and maintains ventricular fi-
brillation. Cardiac arrest induced elec-
trically or by hypothermia is also use-
ful at the end of cardio-pulmonary by-
pass to avoid air embolism.
Many of the early heart-lung systems
had a huge priming volume. For in-
stance, the apparatus used at the Mon
-
real Heart Institute between 1960 and
1962 needed some 3500 to 4000 cc.
The priming fluid consisted at that time
of whole blood, which imposed a tre-
mendous task upon the blood bank.
Today this equipment is simplified and
its priming volume rarely exceeds 1800
cc. To further reduce the quantity of
blood needed for priming, and to
improve capillary perfusion, we dilute
the priming volume with 5 percent
glucose in 0.4 NaCl. The ratio is 2/3
blood and 1/3 dextrose solution. We
JANUARY 1967
THERMAL
EXCHANGER -
Pump
also add electrolytes, mainly KCI, to
prevent postoperative deficit.
Acquired heart lesions
The acquired cardiac lesions now
amenable to surgery are: 1. constric-
tive pericarditis; 2. aurioculo-ventricu-
lar dissociation (A V block); 3. massive
pulmonary embolism; 4. mechanical
complications of myocardial infarction;
5. coronary artery insufficiency (angina
pectoris); 6. traumatic lesions; 7. val-
vular heart disease.
Constrictive pericarditis
Pericardial constriction was not un-
usual several years ago. It was pro-
duced in most instances by a tuber-
culous infection. Now, this disease has
almost disappeared. At the Montreal
Heart Institute, only three such cases
have been admitted for surgery since
1963. The surgical correction consists
of the removal of the thickened and
often calcified pericardium, which acts
as a shell preventing normal cardiac
contractions. This disease, affecting
cardiac filling, is frequently mistaken
for cirrhosis of the liver. Recovery fol-
lowing surgery requires a three to six
month convalescence, but it is quite
spectacular in most cases.
Auriculo-ventricular
dissociation
Auriculo-ventricular dissociation -
also called Stokes-Adams syndrome -
was nearly always fatal within two
years of onset before artificial pace-
makers came into clinical use. In this
ailment, atrial contractions are not
transmitted to the ventricles because
of some organic interference with the
Bundle of His. The rate of ventricular
contraction is often less than 40 beats
per minute and sometimes it reaches
as low as 25 or even 20 beats per
minute. Episodes of ventricular ta-
chycardia or prolonged asystole ensue
and cause inadequate cerebral perfu-
sion resulting in dizziness and/or syn-
cope. During these periods of asystole,
ventricular fibrillation is not uncom-
mon and is followed by sudden death
in most instances.
A V block is mostly a disease of
people in their sixth, seventh, or eighth
decade. It results from a degenerative
process affecting the intracardiac ner-
vous tissue. However, A V block may
follow a large myocardial infarct and
cause a rapid exitus. Treatment of this
condition with drugs such as isoprote-
renol is deceiving. The only sure way
to prevent disaster is to stimulate the
heart with electricity by an apparatus
which may be implanted or used ex-
ternally. To avoid Stokes-Adams ac-
cidents, electrodes are implanted into
the heart using an transvenous catheter
or by a direct transthoracic puncture.
Once the patient is protected by ex-
ternal stimulation, an elective opera-
tion can be performed later which con-
sists of the implantation of a small
transitorized apparatus called a pace-
THE CANADIAN NURSE 33
maker. (Figure 2.)
Several types of pacemakers are in
clinical use. We now prefer a synchro-
nized apparatus (Atricor made by Cor-
dis Corporation) which seems to offer
many advantages over the earlier fixed-
rate models. The synchronous or P-
wave pacemaker provides a better car-
diac output because it regulates the
ventricular contractions to the atrial
systoles. It thus permits variations in
the cardiac rhythm and output ac-
cording to the needs of the body.
The surgical procedure of pace-
maker implantation is simple and its
mortality is very low. Patients as old
as 89 years of age were operated on
successfully at the Montreal Heart In-
stitute and no operative mortality has
been deplored.
Massive pulmonary embolism
In recent years, the heart-lung ma-
chine has been simplified rendering
possible its preparation for cardia-pul-
monary by-pass in a matter of minutes.
The cardiac surgeon is capable of re-
moving massive pulmonary emboli as
an emergency procedure and saves
many lives that formerly were lost. The
treatment consists of extracting the
clots from the main pulmonary artery
and its branches. In most cases the
procedure is complemented by liga-
tion of a plication of the inferior vena
cava to prevent recurrent
mbolization.
At the Heart Institute, preparation for
cardio-pulmonary by-pass can be made
34 THE CANADIAN NURSE
Fig. 2
CARDIAC PACEMAKER
) \
--- - ,. --........
í
, \ \//
/
( . y?Ii3 . . .. . ( ( 4 3 1 ) Cardiac stimulation
'- Wires inserted through the diaphragm
g (2) Rhythmic influx electronic feeding device
; r g (1) Continuous steam power batteries
in 15 minutes for such emergencies.
Mechanical complications of
myocardial infarction
Even though surgery is limited in the
treatment of myocardial infarction,
mechanical complications of this dis-
ease - such as ventricular aneurysms,
perforations of the septum, and rup-
tures of papillary muscles - can be
corrected surgically. After an extensive
coronary thrombosis, some patients
develop an abnormal dilatation of the
left ventricular wall. The dilatation
causes chronic heart failure, mostly
because of its paradoxical motion.
These cases respond poorly to medical
management because the dilated ventri-
cular wall has no contractile strength
and has a paradoxical expansion
during each systole. Cardiac output is
thus markedly reduced. We have cor-
rected four such aneurysms with three
survivals. The operation is rather sim-
ple. The dilated wall is excised, and
the mural thrombus removed. The
ventricular edges are then resutered.
Postoperatively, these patients are
markedly improved and can resume
useful activities.
Perforation of the septum following
cardIac infarction is uncommon. Some
authors report a 50 percent death rate
within the first week after perforation
and a survival rate of only 13 percent
after two months. The surgical pro-
cedure consists of closing the perfo-
rated septum under cardio-pulmonary
by-pass. Three such procedures have
been performed at the Montreal Heart
Institute with gratifying results.
Coronary artery insufficiency
Chronic coronory insufficiency is the
most common acquired heart condition
of our modern time. Until recently,
even adequate medical therapy with
vasodilators or anticoagulants and as-
sociated cessation of all activities was
unable to lower the mortality rate.
For the past 15 years various surgI-
cal procedures have been advocated,
primarly by Beck, O'Shaughnessy and
Vineberg. At present, the implantation
of the internal mammary artery (called
Vine berg's procedure) is currently per-
formed in some 25 Canadian and
American centers. This experience, al-
though recent, is quite encouraging.
Surgical technique consists of im-
planting a systemic artery (the internal
mammary, an intercostal or a venous
graft from the descending thoracic
aorta, etc.) into a myocardial tunnel.
For diffuse coronary artery disease, an
epicardectomy is often added along
with a free omental graft which is
wrapped around the heart muscle.
Postoperative cine-angiographic studies
have shown beyond any doubt satis-
factory patency of the implanted artery
and newly developed collateral bran-
ches. According to more recent studies,
after eight months the blood flow into
the implanted artery is equal to the
flow in a normal anterior descending
JANUARY 1967
Fig. 3
..
""-
'"
,
...
(
coronary artery. These surgical pro-
cedures are promising and will play
an important role in the treatment of
chronic coronary insufficiency.
Traumatic heart disease
Trauma to the heart is not always
lethal, fortunately. If one adopts a
prompt and aggressive attitude, it is
possible to salvage a good proportion
of such cases.
All authors agree that upon admis-
sion, when a cardiac wound is sus-
pected, a pericardial puncture must be
performed. By this maneuver the
diagnosis is confirmed and cardiac
compression, if present, is temporarily
relieved. If cardiac tamponnade recurs,
the heart should be explored and the
wound sutured.
Diseases of the heart valves
Modem cardiac surgery is now con-
centrating its energy in the correction
of valvular lesions. Except in cases of
pure and non-calcified mitral stenosis
(..dequately treated by commissuroto-
my) the correction of valvular disease
requires the insertion of a prosthetic
heart valve. A variety of prostheses are
available, but all have the same hy-
draulic principle of the ball-valve des-
cribed by Starr and Edwards in 1960.
(Figure 3.)
The pros and cons do not differ
much from one type to another. In all,
anticoagulants must be prescribed for
JANUARY 1967
the entire life of the patient. These
artificial valves may become partially
dislodged, throw emboli, or become in-
fected. More recently, Gordon Murray,
Donald Ross, and Barrat Boyes have
popularized the use of homograft
valves. The danger of embolization and
infection seems to be lessened with
these homografts.
At the Montreal Heart Institute,
more than 190 patients have been
operated on for valvular replacement.
Of this group, 27 have had simultane-
ous replacement of two valves, either
the mitral and aortic in 23 cases, or
the mitral and tricuspid in 4 cases.
These patients were operated upon
at a far advanced stage of the disease
and long term results are very satis-
factory. An impressive number of these
patients have returned to a near
normal and productive life.
Conclusion
In recent years, heart surgery has
reached more unexplored goals than
any other surgical discipline. Mter es-
tablishing satisfactory procedures for
several acquired lesions such as val-
vular malfunctions, A V blocks and
mechanical complications of myocar-
dial infarction, cardiac surgery is now
claiming continuing success in the
revascularization of the myocardium.
Coronary artery disease affects, in the
United States alone, more than 25 mil-
lion people. Most authors agree that
Commonly used artificial heart valves.
Left to right: Starr aortic; Starr mitral;
Magovern aortic; Cutter; and Hufnagel
valve.
about 5 million such patients can now
benefit from revascularization proce-
dures. These accomplishments illustrate
the enormous possibilities of surgery
in cardiovascular ailments. A great
number of cardiac cripples can now be
rehabilitated to a useful life. 0
THE CANADIAN NURSE 35
Intensive care unit
cardiovascular surgery
.
In
An intensive care unit for patients
having cardiovascular surgery is de-
signed to decrease mortality rate and
to give patients the benefit of highly
technical care and close observation.
Such a unit, with its up-to-date equip-
ment and well qualified personnel,
helps to eliminate the unfavorable
effects of anxiety and fear that may
predispose to postoperative complica-
tions.
Physical organization
The intensive care unit for cardio-
vascular surgery is not merely a re-
covery room. Patients are admitted
as soon as they come out of the operat-
ing room and the average stay is five
days.
To serve both operating rooms of
the Montreal Institute of Cardiology,
13 beds are provided in two six-bed
units and one isolation room. The iso-
lation room is used to ensure quietness
and privacy to a severely ill patient,
to isolate a patient with an infectious,
disease, or to permit the assembly of
all machines and equipment together in
one area for a seriously ill patient.
A two-bed room is available for
patients who have not had surgery, but
whose condition requires close super-
vision. This includes persons with acute
pulmonary edema, babies or infants
who have had heart catheterization,
and patients being observed after atrial
defibrillation.
Space allotted: Approximately 108
square feet are allotted to each patient.
36 THE CANADIAN NURSE
A description of the intensive care setup at the Montreal Institute of Cardiology.
Cecile Boisvert
This provides sufficient space for
equipment and additional personnel in
case of emergency.
Direct observation: No system of
automation, whether it be heart mon-
itors or other electronic instruments,
can replace direct observation. For
this reason, the central station is
located so that each patient can be
watched at all times.
Waiting room for visitors: Even
though visits are restricted, a waiting
room in close proximity to the post-
operative unit is provided for parents
and relatives.
Air conditioning: A system of air
conditioning is essential, not only for
the comfort of patients and staff, but
also to offset the heat produced by
many electronic instruments. Ade-
quate humidity is also required to keep
mucous membranes moist and to
facilitate expectoration of bronchial
secretions.
Equipment
Oxygen and suction: Each unit has
two oxygen outlets and two wall
suction connections. One suction outlet
is for chest drainage and the other for
oro-nasal or endotracheal aspiration of
our patients.
Miss Boisvert, a graduate of St-Joseph's
Hospital in Trois-Rivières, Québec, special-
ized in cardiology at I'Jnstitut Marguerite
d'Youville in Montreal. She is Head Nurse
of the Intensive Care Unit at the Montreal
Institute of Cardiology.
Electrical: Electrical outlets are
numerous since many electrical de-
vices are used in the various types
of treatment. Five double outlets,
separately fused, are provided per
patient and a special outlet is available
in each unit for taking chest x-rays
at the patient's bedside.
Monitoring and alarm systems for
emerg,encies: The heart monitor is of
special assistance when observing pa-
tients who have had cardiovascular
surgery. Numerous complications and
even fatal outcomes have been avoided
through the use of such devices.
A recently published report of
research undertaken by a team of
physicians and nurses at the Presby-
terian Hospital of Philadelphia states:
"If the heart rhythm can be constan-
tly observed through the use of mon-
itors, and if the equipment necessary
for resuscitation is kept near the pa-
tient, potentially fatal arrhythmias may
be detected and treated instantly. Total
mortality in patients having a myocar-
dial infarct, at the acute stage, may
thus be reduced by almost 50 per-
cent.".
The monitoring system at the Mon-
treal Institute of CardiologV includes
a central complex of monitors which
indicate heart rhythm, ECG tracing,
· Lawrence Meltzer. Rose Pinneo, Roderick
Kitchell, JI/tcllsil'e Corollary Care - A
Mal/ual for Nurses, Philadelphia. The Pres-
byterian Hospital. 1965.
** Ibid.
JANUARY 1967
.
.
.
- t::1.
- t::l.
- t::J.
- t=:].
.
and the curve of the peripheral pulse
of each patient. This central complex
is located in the nursing station and
is connected to the cardioscope at the
bedside.
The monitoring system also contains:
a) An alarm system that warns the
staff if the patient showns signs of
ventricular fibrillation, tachycardia or
bradycardia.
b) A mechanism that operates auto-
matically or on demand to provide a
recording on paper of a particular or
doubtful ECG tracing which the nurse
has been able to observe on the oscil-
loscope. These ECG tapes help the
physician to assess the patient's condi-
tion; for the nurse, they are indisputa-
ble arguments to justify her observa-
tions.
c) A "memory tape loop" that
records and retranscribes on paper the
ECG of the previous three to five
minutes. With this device, it is possible
to determine what happened immedia-
tely before or after the alarm was set
into action.
Needle electrodes: The use of needle
electrodes for ECG has numerous ad-
vantages. They can be installed in a
few seconds - an essential in an
emergency - and eliminate false
alarms and interference because of a
poor skin contact.
Needle electrodes can be left in
place five to seven days without caus-
ing the patient discomfort. The skin
is cleansed with alcohol before the
JANUARY 1967
- t::J.
- t::J e
- t::J.
- t:::].
.
ß
needle is inserted, to eliminate the pos-
sibility of infection.
Emergency equipment
In an intensive care unit, aU equip-
ment and drugs must be kept in a
central location. There can be no com-
promise with this principle.
Emergency cart: All equipment used
for resuscitation is assembled on a
mobile cart that can be rolled quickly
from the central station to the patient's
bedside. This represents savings both
in time and equipment. This cart con-
tains: a). a portable DC defibrillator
with electrodes and conductive jelly; b).
lung ventilation equipment, including
"Resuscitube," intermittent positive
pressure apparatus, and endotracheal
tubes and laryngoscope; c). external
heart massage equipment, including a
wooden board, measuring about 3' x 2',
to place under the patient's chest, or
an automatic mechanical compressor;
d). venous dissection equipment; e).
tracheotomy and tracheal cannulas; 0.
instruments necessary for emergency
thoracotomy; g). drugs, including epi-
nephrine, norepinephrine, Aramine,
[suprel, bicarbonate of sodium, calcium
chloride, and Pronestyl; h). sterile
gloves, syringes, needles, etc.
The contents of the emergency cart
are checked carefully each day and
each time after they are used.
Personnel
The care of patients having heart
surgery involves team work. Good
Eight-bed central station using Selector
Monitor with repeat meters and alarm
lights. A single channel recorder is in-
cluded for automatic or manual opera-
tion.
results cannot be obtained without
close cooperation between each mem-
ber of the team.
Surgeons assume the responsibi-
lity for patients in the intensive care
unit, and the residents in cardiovas-
cular surgery are entrusted with the
supervision of patients during the entire
postoperative period.
Distribution of nursing staff.' Any
patient who has had cardiovascular
surgery requires nursing care of a truly
high caliber. To meet such an objec-
tive, a strict minimum of eight hours
care must be provided for each patient
in a 24-hour period. The nurse's aide
contributes by performing certain tasks,
such as bathing the patient, changing
his bed linen and helping him to eat.
Selection: Careful selection of nurs-
ing personnel is essential. Desirable
personal attributes include: an ability
to learn and assimilate new techniques
quickly; emotional stability, which
allows a person to face emergency si-
tuations efficientlv; good health, since
much physical effort is required in the
unit; a marked interest in and dedica-
tion to this type of work.
Previous experience in a recovery
room or intensive care unit is a great
asset. It is not, however, a requisite for
employment.
Status: Because of the responsibil-
ities that the nurses in this unit must
assume, it is logical that they should
have a distinctivè status and th1t their
experience be recognized.
THE CANADIAN NURSE 37
INTENSIVE CARE UNIT
IN HEART SURGERY DEPARTMENT
CJ CJ CJ CJ
CJ CJ CJ CJ
CJ CJ CJ CJ
CENTRAL MONITORING
STATION PANEL
+
CJ
py
PHARMACY
Salary should be commensurate with
their position. Rose Pinneo, in
Intensive Coronary Care - A Manual
for Nurses, suggests a salary approxi-
mately 15 percent higher than that
of the basic staff nurse. * * This has
become policy at most hospitals.
Staff orientation
Orientation extends over a period
of about three weeks, during which
time the nurse is called upon to assume
increasingly greater responsibilities.
Under the guidance of an experienc-
ed nurse, the new staff member has
an opportunity to observe patients.
This phase of learning is planned in
advance, not left to chance. New tech-
niques are taught whenever the occa-
sion permits.
The surgeons, cardiologist, and resi-
dents present lectures and clinics for
the nurses' benefit. Topics include:
anatomy and physiology of the cardio-
vascular system; pathology of the heart;
surgical operations for heart disease;
drugs used in heart surgery; treatment
of various arrhythmias; postoperative
complications and preventive measures;
oxygen therapy; psychological prob-
lems of patients having heart surgery;
and rehabilitation.
Each staff member is expected to
learn, through personal reading. about
ECG tracings and the various arrhyth-
mias.
Certain techniques and procedures
must be learned. These include: mea-
surement of venous pressure; ope-
38 THE CANADIAN NURSE
ration of the cardioscope and pace-
maker; use of the thermo-regulator
mattress; handling of the various res-
pirators; techniques of resuscitation
and external heart massage; and defi-
brillation in ventricular fibrillation.
At the Montreal Institute of Car-
diology, the nurse has the right, in cer-
tain circumstances, to carry out ven-
tricular defibrillation, that is, to give
the patient an electric shock of 300-
500 watts per second. Ventricular fi-
brillation is an extremely serious
arrhythmia that may cause death if
nothing is done within three minutes.
If the nurse encounters ventricular fi-
brillation in a patient, she must advise
the surgeon immediately; if, after 60
seconds, he has not arrived, she starts
electrical defibrillation to reestablish
normal heart rhythm. In such circums-
tances, the surgeon assumes full res-
ponsibility for her action.
To familiarize the staff with proce-
dures performed in an emergency, a
particularly critical emergency is simul-
ated using a dummy or a member of
the staff as a patient. The nurse must
act exactly as if she were faced with
a real case of cardiac arrest or a pa-
tient who has suddenly developed ven-
tricular fibrillation. Her actions can
then be assessed and she can be hel-
ped to improve her technique and save
time.
Care is never routine
Nursing care in cardiology can never
become a matter of routine. It is given
on an individual basis according to
age, type of disease, seriousness of the
illness and the patient's attitude toward
his condition.
The nurse must also be concerned
with the patient's rehabilitation. She is
in" a better position than anyone else to
help him achieve successful rehabili-
tation.
Nursing care in heart surgery is a
real challenge to any nurse. Although
the work is exacting and the responsibi-
lities heavy, the reward, also, is great.
The nurse is compensated for her ef-
forts when she sees the patient leave
hospital improved or cured and when
she knows that she has given him the
best of her knowledge and skill in the
most difficult circumstances. 0
JANUARY 1967
Varicose veins are characterized by
permanent overdistention and changes
of their waUs. This paper deals with
varicose veins involving the super-
ficial venous network of the lower
limbs, especiaHy those situated along
the internal and external saphenous
veins.
Etiology
Varicose veins usually appear in the
young adult and increase with age.
They occur about four times more
frequently in females than in males.
They are observed especially in per-
sons who must stand at their work for
long periods without moving. Their
development is, moreover, enhanced
by frequent pregnancies.
There is often a hereditary factor in-
volved. Some persons seem to have a
constitutional weakness of the valves of
the veins and an abnormal propensity
to distention of the venous walls. In
a study of 1,500 patients with vari-
cosities, Raymond Tournay found a
hereditary factor in 90.6 percent.
The maternal or the hereditary
influence from the mother's side is
found in 55 percent of patients. Thirty-
three percent of the women with vari-
cosities developed them during their
first pregnancy.
Physiopathology
NormaHy, venous circulation return-
ing from the lower limbs results from
the suction effect of the heart and the
pulsion effect of the muscular massage
IANUARY 1967
Varicose veins of the
lower limbs
About 10 percent of all adults over thirty-five years of age have some degree of
varicose change in their saphenous venous system.
Philippe Dionne, M.D.
on the deep veins and, indirectly, on
the superficial veins. Venous flow thus
goes from the saphenous veins to the
deep veins. Both mechanisms work
against two contrary movements: res-
piration and hydrostatic pressure.
One theory of varicosities is that the
venous backflow pushes the blood from
the deep veins toward the superficial
veins by means of communicating
veins, causing gradual dilatation of the
superficial veins. It is known, however,
that these communicating veins contain
valves that aHow the blood to circulate
only from the surface toward the deep
veins. (Figure 1.) Nevertheless, when
varicose veins have already appeared,
the valves of the communicating veins
may be forced, little by little, allowing
the backflow to by-pass them, thus
increasing varicose distention. This ex-
plains the aggravation of varicose veins.
but not how they started.
At the present time, Trendelenburg's
theory is the one generally accepted:
the appearance of varicose veins is
related to the incompetence of the
ostial valve situated at the opening of
the internal saphenous vein into the
femoral vein. (Figure 2.) The main
branch of the internal saphenous sup-
ports all the pressure of the abdominal-
thoracic blood column, since there is
no valve between this point and the
heart. Thus, the first segment of the in-
Dr. Dionne is a member of the surgical
staff at SI. Vincent-de-Paul Hospital. Sher-
brooke. Quebec.
temal saphenous dilates, and the
valve closing it at the lower segment is
forced. bringing about distention of the
second segment, and so forth. From
one point to the next, the weight of the
blood column exerts pressure right
down to the lower part of the leg.
This valvular incompetency theory
has been proved by clinical and ex-
perimental evidence. Other factors,
too, may cause a lack of venous tonus
which favors distention.
Types
There are two main types of vari-
cose veins: essential or idiopathic, and
secondary, also called substitute or
compensating.
All varicose veins of the lower limbs
are superficial in nature. Certain
authors speak of "deep" varicose veins;
however, the anatomy and physiology
of venous circulation in the lower limbs
allow us to state definitely that the
deep veins are not involved in the
pathological enlargement. Deep varico-
sities just do not exist. The term has
merely been used to describe patients'
complaints of a feeling of heaviness,
strain. and cramps in the calves of the
legs after a long period of standing.
Such discomfort may be the beginning
of the complication of internal rupture,
which will be described later.
Secondary or "substitute" varicose
veins are characterized by dilatation
of the superficial venous system. This
dilatation acts as a compensation fol-
lowing deep vein thrombophlebitis.
THE CANADIAN NURSE 39
2
4
Fig. 1. Diagram showing valves in a
communicating vein. 1) Femoral vein;
2) internal saphenous vein; 3) commu-
nicating vein; 4) normal valve that
opposes flow from the larger vessel
back into the superficial vessel.
40 THE CANADIAN NURSE
Fig. 2. Because of insufficiency of the
ostial valve, the first segnænt of the
internal saphenous dilates with corres-
ponding pressure on the collateral cir-
culation. The second valve is then
forced and the second segmem dilates,
and so on. 1) Femoral vein; 2) pro-
funda femoral vein; 3) superficial
Fig. 4. Top: After elevation of the leg,
compression is applied to the saphenous
vein. Middle: Leg is lowered and
varicosities do not appear. Bottom:
When compression is stopped the
varicosities immediately appear.
\.
,
.
,
,
Fig. 3. Varicosities of lower leg.
femoral vein; 4) first segment of
internal saphenous vein; 5) ostial
valve; 6) second valve,. 7) openings of
collateral saphenous circulation.
Fig. 5. Left: Subject standing - severe
varicosities apparent. Middle: Subject
lying down, leg in air - varicosities
collapse. Right: Subject standing with
tourniqu,et obstructing the internal
saphenous - varicosities remain col-
lapsed, but are scarcely visible. When
the restriction is removed, the varico-
sities will fill up from top of leg toward
ankle, which indicates valvular insuf-
ficiency at the junction of the internal
saphenous.
JANUARY 1967
"
Fig. 6. Varicose ulcer.
Secondary varicose veins are late
complications that can be caused by
deep thrombophlebitis in the same man-
ner as the post-phlebitic syndrome and
the post-phlebitic ulcer (stasis ulcer).
Essential or idiopathic varicose veins
represent the group of common vari-
cose veins that develop spontaneously
in the absence of deep venous obstruc-
tion. A hereditary factor is involved.
Anatomic pathology
At first, the clusters of varices
remain localized in restricted areas. Af-
ter progressing for a certain time,
the varices finally invade the whole
area of the internal saphenous vein
and sometimes also the area of the
external saphenous.
Macroscopically, the affected veins
are dilated, tortuous, and fluctuant,
due to their secondary lengthening.
Their walls are usually thin and calci-
fied in places. The dilatations often
wntain calcifying clots (phleboliths).
Under a microscope, a thickening of
the tunica can be seen in the early
stage of the varix. Later, this is re-
placed by atrophy with sclerosis.
Changes occur in other tissues of
the limb. The sclerous tissue around
the varices finally reaches the nerves
and the artcries; the subcutaneous cel-
lular tissue atrophies and becomes the
site of an edematous infiltration. The
skin also undergoes important changes.
It becomes white and glossy in places,
dry, scaly, and pigmented in others.
Eczematoid lesions appear and the skin
JANUARY 1967
soon becomes badly ulcerated.
Clinical picture
Few functional symptoms are evident
at first. The patient may complain of
heaviness and fatigue of the limb, with
malleolar edema in the evening, in-
creased by standing. Later, he may
experience acute pain in the form of
leg cramps.
The physical signs consist of veins
that are dilated in the form of bluish
cords, and uneven flexuosities, situated
most frequently along the internal sa-
phena, Le., along the inner surface of
the thigh and the leg. Varicose veins
partly disappear when the patient is
recumbent in the supine position. They
can be partially reduced by pressure.
(Figure 3.)
The Trendelenburg test helps to de-
termine the location of incompetent
valves. With the patient lying down,
the leg is elevated to empty the super-
ficial veins. The outlet of the saphena is
compressed and the patient then is
asked to stand. If the ostial valve is
incompetent, the varicose veins fill
again suddenly from the top to the
bottom as soon as the digital compres-
sion is removed. (Figure 4.)
The Trendelenburg test may also
be used to demonstrate incompetent
perforating veins. The limb is raised
to empty the saphenous; the outlet of
the saphenous is compressed, and the
limb then is lowered without stopping
compression. If the perforating veins
have competent valves, the vein fills
slowly; if the perforating veins do not
have competent valves, filling occurs
rapidly. (Figure 5.) The multiple-tour-
niquet test is also helpful in locating
the position of incompetent perforating
veins.
Perthes' test, which consists of com-
pression of the saphenous trunk in the
thigh followed by exercise carried out
by the patient, is useful to evaluate
the patency of the deep venous system.
If the deep veins are blocked, the vari-
cosities become enlarged and the pa-
tient feels a pain in the calf of the leg.
Phlebography supplies two types of
information: it helps the physician to
evaluate the deep circulation and to
localize the incompetent perforating
veins.
Complications
Complications represent the serious
aspects of varicose veins.
1. Rupture: External rupture occurs
through a gradual thinning of the
dermis over a dilated varix. Suddenly,
without apparent cause or pain, the
hemorrhage occurs. Although it may
be serious, it can usually be controlled
by elevating the limb and applying a
pressure bandage.
Internal rupture occurs over the
deep veins of the calf. The patient ex-
periences a sharp and sudden "whip-
lash" pain followed by lameness. In the
ensuing days a painful induration ap-
pears over the calf of the leg, oc-
casionally accompanied by ecchymosis.
2. Varicose phlebitis: This com-
THE CANADIAN NURSE 41
plication, which generally involves the
superficial varicose veins, is common.
Clinically, edema and local erythema
are noted. The venous cord becomes
hard, knotty and painful. Sometimes
the phlebitis will extend the entire
length of the internal saphenous. It
rarely gives rise to emboli, but is
stubborn and recurring. More often
than not, the inflammation subsides,
leaving an indurated cord; however,
it may progress to suppuration.
3. Trophic skin: Patches of pig-
mented skin and dry or oozing eczema
are commonly found.
4. Varicose ulcer: This is the most
common and most serious complica-
tion, since it resists treatment and
recurs easily. (Figure 6.) Its pathogeny
is complex. Nutrition of the tegument
of a varicose limb is poor for two
reasons: venous stasis and nerve
changes as a result of sclerosis.
Clinically, the varicose ulcer is observ-
ed most frequently in the lower half
of the inner surface of the leg. It
begins following minimal excoriation
of the skin, caused by trauma or
eczema.
The ulcer gradually enlarges and
may reach considerable dimensions.
Its edges are sharp, quite regular, thick
and adherent. The base of the ulcer is
irregular, greyish, and atonic, and
secretes a turbid serous discharge. The
skin surrounding the ulcer is brownish
in color. If not treated properly, the
ulcer gradually increases in size. With
adequate treatment it may be cured,
but it recurs with extreme facility.
The common varicose ulcer must be
differentiated from the post-phlebitic
chronic ulcer or "stasis ulcer," which
represents a separate entity. The latter
is found in patients who have suffered
deep phlebitis of the lower limbs some
years previously and who, afterwards,
have shown the syndrome known as
the "post-phlebitic leg": vague pain; a
feeling of heaviness, fatigue, and
cramps in the affected limb; and the
appearance of hard and sometimes
ligneous edema. At first, the skin has
a smooth, glossy appearance with
brownish-red pigmentation.
Although varicosities may not exist
prior to or during the course of the
42 THE CANADIAN NURSE
phlebitis, they may appear later. After-
ward, the ulcer sets in and resists
almost any type of treatment.
Our present knowledge of the causa-
tive mechanism of "stasis ulcer" now
enables us to treat it successfully with
surgery. Deep thrombophlebitis, in its
acute phase, completely blocks the
deep vein of the limb. With time and
treatment, the acute phase subsides.
Later, the vein becomes more or less
permeable again, but like a rigid tube,
having lost its elasticity. Muscular mas-
sage is no longer effective; hence, there
is a backflow through the communicat-
ing veins and a consecutive stasis in the
superficial venous network with the
onset of substitute varicose veins and
a stasis ulcer.
Treatment
Uncomplicated essential varicose
veins are relatively easy to manage.
Small varices that give little trouble can
be treated by having the patient wear
elastic stockings; the compression thus
achieved is sufficient to prevent the
evolution of lesions. If, however, the
patient refuses to wear elastic stockings
permanently, sclerosing solutions can
be injected particularly in the case of
moderate and well-localized varicose
veins. The injection of sclerosing solu-
tions has a positive effect; this treat-
ment involves little risk, allows the
patient to be ambulatory, and has the
advantage of curing the disorder with-
out leaving scars. The injected scleros-
ing solution induces a localized obli-
terating endophlebitis which transforms
the varix into a solid cord.
The purpose of the sclerosing treat-
ment is to prevent lesions and later
complications from developing. It will
give excellent results if it is started
early and if the patient regularly visits
his physician to have him sclerose any
ulterior varicose dilatation. It will be
more effective if the patient is well
aware of his or her condition and
understands the importance of wearing
elastic stockings.
If, however, the patient refuses to
wear such stockings; if he or she does
not want to undergo the continuous
sclerosing treatment; if the varicose
veins are enormous; or if the patient
shows one of the serious complications
of varices, surgery is the only effective
treatment. The latter consists of the
division of the great saphenous vein
at the saphenofemoral junction, with
ligation of all its collaterals, and the
stripping of the entire internal saphe-
nous vein from the groin to the internal
malleolus. lf indicated, the perforating
veins, especially those in the upper
third of the leg, are ligated as well.
Sclerosing solutions may be injected,
if necessary, pre- or postoperatively to
avoid too many scars. After surgery, a
compression bandage is applied to the
limb to prevent hemorrhage.
Walking is resumed the following
day to avoid stasis and deep thrombo-
ses. The functional and esthetic re-
sults of such operations are excellent.
The destruction or eradication of
the varicose veins by surgery automa-
tically cures a varicose ulcer. If,
however, the ulcer is of a large di-
ameter, over 2 cm., for instance, its
recurrence will be prevented by ex-
cising the ulcerated area and applying
a dermo-epidermal graft.
The recurring post-phlebitic ulcer
(stasis ulcer) is treated surgically ac-
cording to a special technique, after
the surgeon has made certain that the
deep circulation is adequate. The ulcer
is widely excised to the level of the
fascia; then, the underlying perforating
veins are ligated even beyond the
fascia to block the backflow to the
surface. Frequently, the detachment of
a large flap that includes the fascia
helps the surgeon to ligate the perforat-
ing veins beyond the ulcerated areas.
Finally, a dermo-epidermal graft com-
pletes the procedure.
Secondary varicose veins that ac-
company the ulcer are treated as essen-
tial varicose veins. Faced with a
varicose ulcer and varices complicated
by obstruction of the deep circulation,
the surgeon has the worst problem to
solve. The stripping of part of the
varicose veins may improve the limb.
In addition, instructions to the patient
about the importance of decreasing
stasis and avoiding trauma, even the
slightest one, may help him to avoid
complications and minimize his dis-
ability. 0
JANUARY 1967
The patient who is to have ligation
and stripping of varicose veins is
usually admitted one or two days prior
to surgery. Preoperative nursing care
is started immediately.
Preoperative care
The patient is allowed out of bed
only to go to the washroom. She wears
elastic bandages on her legs at all times
to prevent blood stasis in the veins.
The nurse explains and demonstrates
the correct procedure for applying the
bandages.
Two four-inch-wide bandages are
used for each leg and are applied by
the patient before rising in the morn-
ing. Prior to this she elevates both
legs for about four minutes to drain
blood from the veins by gravity.
To be useful, the bandages must be
applied correctly. Wrapping should
start close to the toes, with three turns
around the foot and three figure-8
turns around the ankle. The second
bandage is then continued up the leg,
using spiral-reverse turns to provide
better support and to avoid uncomfort-
able folds. The compression of the
bandage must be strong over the feet
but less at the ankles and the calves,
to avoid edema of the feet and toes.
The foot of the bed should be raised
by two or three notches (about eight
inches).
Physical preparation also includes
teaching the patient the various respir-
atory and spirometric exercises that
she will be required to carry out post-
operatively.
JANUARY 1967
Nursing care in
. .
varicose vein surgery
Teaching the patient ways to help prevent the recurrence of
varicosities is an important aspect of care.
Murielle Rodrigue
Psychological preparation is as im-
portant as physical. All procedures are
explained to the patient, and she is
given an opportunity to express her
fear of pain and discomfort. In certain
cases, apprehension may be due to
fear of the recurrence of the varico-
sities after surgery. The nurse explains
that the operation is a successful form
of treatment, and that active treatment
at this stage will avoid later complica-
tions such as phlebitis, ruptures, vari-
cose dermatitis and ulcers.
On the evening before surgery the
pubis and both legs are shaved. Shav-
ing is done carefully, since the skin
over the varicose veins is very thin and
fragile. Cuts and scratches could lead
to infection and thus to postponement
of the surgery. The risk of infection is
reduced by applying Betadine soap,
which contains 0.75 percent of free
iodine, to the legs.
The nurse takes this opportunity to
explain to the patient the dangers of
using a depilatory cream, especially if
there is an ulcer. These substances are
much too irritating for delicate skin
and may cause a dermatitis to develop.
Postoperative care
A cradle is placed on the patient's
bed to prevent the weight of the bed-
clothes from resting directly on her
legs. The foot of the bed remains rais-
Miss Rodrigue is Supervisor and Clinical
Instructor of Surgical Nursing at the St.
Vincent de Paul General Hospital School
of Nursing in Sherbrooke. Quebec.
ed by 8 inches to aid venous return.
In addition to routine supervision,
the nurse closely observes the incisions
in the region of the groin, knee or
instep for possible hemorrhage or
hematomas. If there is bleeding, she
applies manual pressure over the area
and notifies the doctor. She also notes
the color of the skin and any edema of
the toes.
Except by order of the physician,
bandages around the legs are not re-
moved. Only the surgeon or his assis-
tant changes the dressings.
The patient is encouraged to move
her toes, ankles, and legs as soon as
possible after the operation, even if
this is painful. The nurse remains with
her as she attempts these exercises for
the first time, to give her moral sup-
port. She explains that the stitches will
not give and that the sooner and more
frequently the patient makes these
movements, the sooner the pain will
disappear. Generally the patient is al-
lowed to walk the day after surgery.
Early ambulation
The patient may complain of a tug-
ging pain over the groin, caused by
the dressing and the stitches, when she
first walks. She is warned not to touch
the dressings, as there is a risk of
contaminating the wound. If edema ap-
pears in the limb during ambulation,
the patient is put back to bed with
her legs raised on pillows.
The patient should walk about and
not remain standing. It is preferable
for her to get up several times a day
THE CANADIAN NURSE 43
for short periods each time. When she
is sitting, she should prop her legs on
a stool.
t
Convalescence
The nurse gives the patient general
instructions about future care to
prevent the recurrence of varicosities.
She advises the patient to continue to
wear the elastic bandages until the
doctor suggests that she wear elastic
stockings. Both stockings and bandages
should be put on in the morning and
left on until bedtime.
The patient is told that she can
prevent dryness of the skin and scaling
by applying vaseline or a lanoline-base
oil; any other medicated ointment
should be avoided. In addition, she
should not scratch her legs, because of
the danger of producing a varicose der-
matitis.
The nurse explains why the patient
should avoid wearing stocking sus-
penders or panty girdles which com-
press the veins in the area of the groin
and the thigh. She warns the patient
against crossing her legs when sitting,
and standing for prolonged periods.
She suggests that the patient should
raise the foot of her bed at night, and,
two or three times during the day,
allow about 20 to 30 minutes of rest
with legs elevated.
The patient is told to avoid any
trauma that might bruise, scratch or
cut her legs. If her limb is injured in
any way, she should inform her phy-
sician.
Patients suffering from varicose
veins should consult their physician
regularly two or three times a year,
especially if they have undergone
surgery. This enables the surgeon to
give better follow-up care to his patient
and to find out if she has really
followed his instructions. 0
, \
-
}
\
....
...
..
The nurse explains and demonstrates
the correct procedure for applying
elastic bandages to the legs.
JANUARY 1967
44 THE CANADIAN NURSE
Effectiveness of nursing visits
to primigravida mothers
The purpose of this project was to
study the effects of public health
nursing visits on the concerns of the
young primigravida mother with her
first baby. Two groups of mothers
were used: one group had public health
nursing visits, and the second group
had no visits by a public health nurse.
The concerns of the mothers in the
study were assessed at two time in-
tervals: once during the mother's stay
in hospital, and again after she had
been at home with her infant for four
weeks.
Need for the study
The increasing demands for service
from the other program areas of pub-
lic health nursing have focused atten-
tion on the traditional maternal and
child health services of the public
health agencies. Public health nurses
are faced with the dilemma of con-
tinuing with an established educational
program or of abandoning it in favor
of the pressing needs to provide new
home care programs or rehabilitative
services.
Two arguments are most frequently
used for either changing or maintain-
Miss Brown, a 1965 CNF Scholar, is a
lecturer at the University of Western Ontario
School of Nursing, London, Ontario. She
based this article on a project completed
in 1965 as partial requirement for her
M.S.N. degree at Western Reserve Univer-
sity, Cleveland, Ohio. The complete thesis
has been deposited in the CNA library.
JANUARY 1967
On testing the hypotheses that primigravida mothers who had public health
nursing visits during and at the end of their first four weeks at home would have
fewer, and less intense, concerns about infant care than mothers who did not
receive visits, the author reached some surprising conclusions.
Louise S. Brown, B.Sc.N., M.S.N.
ing the nursing service. One IS that
the mother of today receives all the
help she needs from her family physi-
cian and from the body of knowledge
she has acquired through her reading
and general education. The public
health nurse, therefore, would spend
her time more profitably by limiting
her visits to those families who either
have requested her visits or who have
obvious health needs. This means
that routine visits to all postpartum
mothers should be eliminated and
only visits on a priority basis be under-
taken by the public health nurse.
The other point of view is that the
maternal and child health program is
the basis of a public health nursing
service, and through it many beginning
health problems are discovered. It is
in this early mother-child relationship
that the foundations are laid for the
child's future development and health.!
The public health nurse is most help-
ful by providing assistance to the
mother in understanding her child's
growth and development and her new
role as a mother. To do this effective-
ly, she needs to visit the homes of all
new parents to assess how she can
help these expanding families. While
assisting the young parent, the public
health nurse also achieves two of the
basis tenets of a public health service:
the promotion of health, and the pre-
vention of disease.
The Expert Committee of the World
Health Organization states that a pro-
gram of health services will be effective
if it is built on the needs of the people
served.:! The public health nursing
programs must meet the same cri-
terion. Research is needed to determine
the needs of the mother and the effect
of public health nursing visits on these
needs. Until this kind of information
is available, there is no scientific evi-
dence to support either of the two
previously stated points of view, that
is, to limit or to expand the public
health nursing program in maternal
and child health.
The investigator developed the fol-
lowing research design to discover the
concerns of the new mother and the
effect of public health nursing visits
on her concerns.
Review of the literature
No literature is available on the ef-
fectiveness of public health nursing vis-
its to the primigravida mother. There
are, in fact, only a few studies 3 . 4. 5. 6. 7
that discuss the public health nursing
programs in the area of the mother
and her infant. * These studies have
assessed the existing services in ma-
ternal and child health at prenatal
classes child health centers, and in
home visits. Of the studies, only those
* Since this study was completed, another
study by Dr. H. Carpenter has been publish-
ed: The Need for Assistance of Mothers
with Their First Babies During the Three-
Month Period Following the Baby's Birth.
Toronto, Univ. of Toronto, School of Nurs-
ing. Alumni Assoc., 1965.
THE CANADIAN NURSE 45
done by Hunter and Carpenter
' a
focus upon the help the public health
nurse provides in her home visits to
the mother with her newborn infant.
A study done by Adams, R while not
discusing the role of the public health
nurse, explores in detail the "early
concerns" of the primigravida mother
about the care of her infant during
the first four weeks at home.
Hunter's study analyzes the routine
visits made by public health nurses in
a large city to all newborn infants.
The method of study is to ask the
public health nurse to complete a
questionnaire following each of 10
visits to a mother and her newborn
infant. The result is an interpreta-
tion of the value of the service by
the participating public health nurses.
Eighty-one percent of the nursing visits
are judged to be valuable. The study
concludes that the service is meeting
a need but that the need has changed.
The physical needs of the infant have
become less of a problem to the mother
since, in most cases, the mother is
able to handle this herself. The new
needs are reported to be: the mother's
feeling toward her baby, her own
problems, and problems in family
dynamics. 4
I Carpenter's study is an analysis of
home visits by the public health nurse
to mothers of newborn infants resid-
ing within the area of a health unit.
The home visits are analyzed through
the use of tape recorders and ob-
servers. It is found that of the 38
mothers of first children, 20 asked
the nurses about the normal growth
and development of their children. 3
What these questions are, and how
the public health nurse assisted the
mothers in finding the answers is not
reported. ** Because of the anxiety
expressed to the nurses and the reports
made by the observers, Carpenter re-
commends in her study that the mother
with her first baby should be given
priority upon public health nursing
time. She recommends, also, that to
be most useful, this service should be
available as soon as possible after the
mother's return home from hospital. 3
The third study by Adams is an
exploratory one to determine: 1. the
concerns of the primigravida mother
in caring for her infant; 2. how these
change over a period of time; and,
3. whether or not they are related to
the infant's birthweight. The samples
used are 20 primigravida mothers of
** Carpenter's second study of the need
for assistance of mothers with first babies
identifies many concerns about infant care.
Most of these concerns are used by this
investigator in developing the tool for as-
sessing the effects of public health nursing.
46 THE CANADIAN NURSE
infants of normal birthweight and 20
primigravida mothers of infants of
premature birth weight. The 40 mothers
are interviewed at three time periods
throughout the first month of infant
care, once in the hospital and twice
at home. Five areas of worries are
described: feeding, bathing, crying,
care of the navel, and/or circumcision,
and other. Feeding is the major con-
cern for all mothers throughout the
month. "Other concerns" rank second,
and crying is third. Birthweight does
not influence the results of the study.
rt is further stated that the early
days of care in the hospital and at
home may be times of "special needs"
for new mothers. Mothers of infants
of premature weight in the study rely
on nurses in helping to care for their
newborn infants. Mothers of children
of normal birthweight use their family
and friends to help them. It is not
reported whether or not public health
nursing visits were made to all the
mothers in the study. A recommenda-
tion made in this study is that a nurse
working closely with the physician
could answer the mother's questions
and convey information to him about
the mother's progress in caring for
her infant. 8
In summary, the studies by Hunter
and Carpenter approach the public
health nursing services through the
public health nurse. No attempt is
made to ascertain from the mother
what her concerns are in regard to
infant care.t The study by Adams,
on the other hand, concentrates on the
mother's concerns, but there is no evi-
dence that the effect of the public
health nurse is considered.
Because of the lack of literature
about the effect of public health nurs-
ing visits on the fears of mothers in
caring for their infants, the following
research proiect was developed to
examine it. The design combines the
studies done by the aforementioned
investigators, the effects of the public
health nursing service, and the con-
cerns of the mother about infant care.
The primigravida mother is begin-
nine; her experience as a mother and
will not have learned to adjust to the
problems of child care, while the
mother with other children has learned
how to care for infants and has an
established pattern of child-rearing
methods. The primigravida mother has
many problems associated with infant
care as demonstrated by Adams' study.
She seems to want help as indicated
bv Hunter and Carpenter. The mother
with her first-born child was selected
t In the second study by Carpenter, infor-
mation is obtained from the mothers to as-
certain their needs.
for this project because of the above
observations. The study by Adams
was of considerable value in defining
terms and in the construction of the
instrument used in this study.
Hypotheses tested
For the purpose of this study, the
following hypotheses were tested:
I. Primigravida mothers who have
public health nursing visits will have
significantly fewer concerns about the
care of their infants than mothers
who do not have public health nurs-
ing visits during the first four weeks
they are at home with their infants.
2. Primigravida mothers who have
public health nursing visits will have
a significantly greater reduction in the
intensity of the concerns that still re-
main at the end of the four weeks at
home than those mothers who do not
have public health nursing visits.
Terminology
Primigravida mother as us
d in this
study is a woman who has given birth
to her first child and who has never
lost a previous pregnancy.
A concern is any aspect of infant
care that worries a new mother.
Intensity of concern is the degree
of the concern as judged by the mother
on a scale ranging from no concern to
extremely concerned.
Newborn infant is any infant born
to the mothers in the sample who are
of normal birthweight and are without
any physical defects.
Public health nursing visits are visits
made by a nurse employed by a volun-
tary or an official health agency to
the primigravida mother in her home.
Methodology
The mothers in this study were
drawn from the regular admissions to
the maternity wards of primigravida
mothers after their delivery. Their se-
lections was made according to the fol-
lowing criteria:
1. The mother is 20 to 29 years
of age inclusive.
2. The pregnancy is without recog-
nized complications.
3. The mother does not have an as-
sociated illness and is well and able
to care for her infant.
4. The mother has delivered a normal
infant of normal birthweight and with
no physical defects.
5. The mother and her child are
under the care and supervision of a
family physician.
6. The mother is married and living
with her husband.
7. The husband is currently employed
or has a means of income not con-
sidered to be welfare.
Two hospitals were used in the
JANUARY 1967
,
'-
...
\
I\
,
\..
IANUARY 1967
-
......
\ I
,
...
;.
., ...
, .
....
..
study and the first 20 mothers who
met the criteria from each hospital
were designated as Group A and
Group B respectively. Group A moth-
ers had visits from a public health
nurse and Group B mothers did not
have public health nursing visits.
The sample mothers were contacted
twice: on the third or fouth day post-
partum in hospital, and after they had
been at home caring for their infants
for four weeks. At both of these times
the mother was asked to complete the
same questionnaire about infant care.
In hospital the mothers were contacted
personally by the investigator. The
second contact was made by mail.
The instrument used in the study
was a questionnaire developed by the
investigator from her personal exper-
iences as a public health nurse and
from writings on child care, especially
the article by Adams. 8 It attempted
to assess the level and intensity of the
mother's concerns about infant care in
the following broad areas: bathing,
crying, feeding, elimination, routine
care, and sleeping. Three of these
areas, feeding, crying, and bathing,
were found by Adams to be problems
for the mothers.
The mothers were also asked to
rank the six areas of infant care in
order of their importance to them and,
after four weeks, to indicate the three
most helpful persons to them during
the past four weeks, and the number
of physician contacts they had made.
Identifying data about the mothers
were taken as well as some indication
of their knowledge and experience in
child care.
The chi-square test was used to
support or reject hypothesis one. The
test for hypothesis two was the Mann-
Whitney V-test. Any differences oc-
curring beyond the 5' percent level of
chance were considered significant in
applying these tests.
The findings
Forty primigravida mothers were in
the sample and all 40 mothers return-
ed the first questionnaire. All but one
returned the second questionnaire.
This mother was in the group with
public health nursing visits.
The tests revealed that for this study
the two groups of mothers could be
considered to be from the same popu-
lation except for the level of educa-
tion and the number of mothers who
worked following their marriages. The
non-service group of mothers had a
higher educational level, worked less
frequently following their marriages,
and tended to have more help at home
with their infants. The control group
of mothers lived in a geographically
different community from the mothers
THE CANADIAN NURSE 47
with public health nursing service. No
attempt was made to assess the socio-
economic levels of the parents. The
mothers in Group B probably had
an advantage here as well, since educa-
tion is one indicator of this status.
Hypothesis One
In general, sample A mothers in-
dicated more concerns at time one in
all areas of infant care except crying.
This group had more "not stated" re-
sponses than Group B. At time two,
the same trends continued with one
exception. The test mothers also re-
ported fewer concerns than the control
group about feeding their infants.
Bathing: Both groups showed a re-
duced number of concerns about bath-
ing their infants from time one to time
two. Although these results were great-
er for the mothers with nursing care,
the difference was not significant and
hypothesis one was not supported.
Crying: The number of concerns
about the crying of the infants was
significantly reduced for each group
after four weeks. The results, how-
ever, did not indicate a significant
enough difference between the two
groups to support hypothesis one for
crying.
Feeding: At time one, the mothers
in sample A had significantly more
concerns about the feeding of their
infants. At time two, there was a sig-
nificant reduction in the conceFns of
the primigravidas with nursing care,
while the mothers without this help
did not achieve this. Hypothesis one
was supported for feeding.
Elimination: No real difference was
indicated for either group of mothers
after four weeks of caring for their
children. Hypothesis one was not sup-
ported for the primigravida mother's
concern about her infant's elimination.
Routine care: Although each group
of mothers was able to reduce her
concerns about the routines of infant
care significantly from the time in
hospital, the difference between the
groups after four weeks was not ade-
quate to support the hypothesis.
Sleeping: The control mothers show-
ed significantly fewer concerns about
the sleeping habits of their infants
than the mothers with nursing care
at both times. The change in the num-
ber of concerns from time one to time
two, however, was not significant
enough between the groups to support
the hypothesis.
Hypothesis Two
In general, at time one in hospital,
the scores of the intensity of the con-
cerns about all areas of infant care
were higher for those primigravidas
who had public health nursing visits.
48 THE CANADIAN NURSE
At time two, the total scores for each
concern was reduced except for sam-
ple B in the area of sleeping. This
score was elevated at time two.
Bathing: Both groups of mothers
showed a reduction in the intensity of
their concerns in this area to well
below the level of chance over the
four-week period. The difference be-
tween the groups, however, was not
sufficient to support hypothesis two
for bathing.
Crying: After four weeks at home,
the mothers in sample A had not
shown a significant reduction in the
intensity of their concerns over their
infants' crying. This, however, did not
hold for the mothers without nursing
care. The results obtained were very
significant and in the opposite direc-
tion to that proposed by the researcher.
Feeding: The in-hospital data col-
lected from the mothers were signifi-
cant for the mothers in the test group.
These mothers had a much higher
intensity score about the feeding of
their infants. After four weeks they
were able to reduce this score to a
level of probability of less than .005.
Group B, on the other hand, had no
significant change in either direction.
Hypothesis number two was accepted.
Elimination, routine care, and sleep-
ing: The null hypothesis was accepted
for these three areas. No statistically
significant data were obtained and
hypothesis two was -not supported.
Public health nursing visits made no
appreciable difference in the intensity
of the mothers' concerns about the
elimination, routine care, or the sleep-
ing of their infants.
For both groups of mothers at the
two times, crying ranked first and
feeding second. There was some shift-
ing of the other four areas at the two
times tested, and the differences ob-
tained are questionable as to prefer-
ence over another concern.
A difference also appears in com-
paring the ranks of the mothers in this
study with areas of concern as found
by Adams. 8 The sample as a whole
placed crying first and feeding second.
In Adams' study, the reverse was
found. Primigravida mothers with and
without nursing service listed their
husbands first and their mothers sec-
ond in terms of helpfulness to them
over the four-week period. The third
most helpful person for group A moth-
ers was the public health nurse. She
was ranked first by three of eight pri-
migravidas in the sample.
In all cases, it was the mother who
was visited by the nurse from the
voluntary agency who indicated the
nurse as helpful. In one unsolicited
response, however, a mother who was
visited by a nurse from the official
agency wrote in the following state-
ment at the end of a lengthy note
about her infant's crying: "I found that
if for nothing else it helps to talk with
the public health nurse because it reas-
sures you and you can ask about small
worries without having to disturb your
doctor."
In third place for Group B mothers
was a variety of other family mem-
bers. The physician was placed fifth
by both groups.
The number of physician contacts
also varied for each group. The moth-
ers with nursing visits had an average
of 2.5 physician visits, while the
mothers without nursing had an aver-
age of 2.0 visits.
Two mothers from sample A and
three mothers from sample B had no
contact with their physicians during
the period of the study. The maximum
number was five contacts made by
two primigravida mothers in Group A.
One mother in Group B had as many
as 10 contacts with her physician dur-
ing the study period.
Discussion and conclusion
The long term purpose of this study
was to find objective evidence to use
in the following controversy in public
health nursing programs: the contin-
uance of a maternal and child health
program as opposed to the curtailment
of this service in favor of newer pro-
grams in other areas. The literature
available to the investigator was limit-
ed and none of the reports attempted
to compare two groups of primigravida
mothers - one with nursing care and
one without - to clarify the effects
of public health nursing services. The
results of the present study do not
strongly support either of the two
arguments. In spite of limitations in
its sampling, the data do point out
pertinent directions for further study
of the controversy.
The major findings of this study
were: The public health nurses had a
positive effect upon both the number
and intensity of the primigravida moth-
er's concerns about the feeding of her
infant. A second major finding was in
the opposite direction than predicted
by the investigator. Although no differ-
ence was found with the group of moth-
ers who had public health nursing care
for numbers of concerns about crying,
the primigravida mothers who did not
have visiting nurses had a greater re-
duction in the intensity of their con-
cerns about their infant's crying.
In comparing the changes that oc-
curred within each group over the
four weeks for the total sample, there
was no reduction made in either the
number or the intensity of concerns
about the infant's sleeping. Bathing
JANUARY 1967
concerns were reduced both in num-
ber and intensity for all primigravidas.
No reduction in the intensity of the
concerns for elimination and feeding
was evident, although the numbers of
these concerns were reduced for all
primigravidas over the four weeks.
The findings relating to feeding and
crying suggest that the effects of pub-
lic health nursing visits require further
study. Why do mothers without nurs-
ing care have reduced intensity of con-
cerns about crying? Why does the pub-
lic health nurse produce improvement
in the mother's concerns only in the
area of feeding? Answers may be with
the quality of an instrument to assess
these areas accurately and it may also
be in the quality of the nursing service
given. Such questions could be answer-
ed by further study using three groups
of mothers: one without public health
nursing, one with the usual public
health nursing, and a third group of
mothers given excellence in nursing
care by a select group of nurses with
controlled supervision.
Another factor that influences the
number and intensity of concerns lies
with the mothers and cannot be con-
trolled. The mother, in hospital before
she has had any experience with her
own infant, seems unable to assess ac-
curately what areas will be of concern
to her and how much of a concern.
Some areas that are not problems in
hospital become major problems as
the child grows. Other concerns disap-
pear completely as the new mother
benefits from her experience. All the
mothers in the sample ranked crying
as number one and feeding as number
two while in hospital, and later after
four weeks. Adams also found crying
of major importance but it was second
to feeding. s In that study, however,
no public health nursing services were
available and half of the mothers gave
birth to premature children.
The results in the present study are
ambiguous. Feeding was positively im-
proved for the mothers with nursing
service. Still, these mothers ranked
feeding second as did the non-service
mothers. Crying was reduced in in-
tensity for non-service mothers, yet
they continued to rank it first as did
the mothers with nursing service. The
limitation in the study's sampling ap-
pears to have some influence on this.
A possible cultural variation in what
is seen as a concern appeared between
the two groups before the mothers had
any experience with their children.
Some of the non-service group of
mothers also had "extended visits"
with their infants in hospital plus ad-
ditional help in the home, which may
have influenced their interpretation
and intensity of concerns.
JANUARY 1967
A very important finding in this
study results from the ranking of in-
dividuals in terms of "helpfulness."
There is, in fact, a need to clarify this
whole area. Mothers in the entire sam-
ple ranked their husbands first and
their mothers second in helpfulness.
Those mothers with public health nurs-
ing services ranked the nurse third,
while the non-public health nursing
group ranked other family members
third. The question of how a mother
views help is not answered in this
study. It is observed. however, that the
primigravida's husband and mother are
with her throughout the 24-hour pe-
riod, and undoubtedly give assistance
in the care of the baby and home.
Physician services were used differ-
ently by the two groups. The mothers
with public health nursing care con-
tacted their physicians more often and
only two in the group were in touch
with him as many as five times. On
the other hand, those primigravida
mothers without service reported con-
tacting their physicians less often. One
mother, however, stated that she con-
tacted her physician 10 times in the
four weeks. The investigator believes
that the mothers with nursing care
used their physician services more
wisely than the mothers without care.
Before this conclusion can be made,
however, further study of this whole
area of "helpfulness" and what per-
sons are "helpful" is needed.
As stated previously, more work is
needed to improve the sensitivity of
the study's instrument and its ability
to discriminate differences. The weight
assigned by the mother was not ac-
curately assessed. One mother ranked
feeding first, but in ranking the scores
for her, crying was first and feeding
further down the list. In reviewing her
responses, it is observed that she had
fewer concerns about feeding and that
only one of these did she rate high in
intensity. This aspect concerned the
amount of breast milk the baby should
get. Clearly, the mother ranked this
above all others. Before using this ins-
trument in further studies, all non-dis-
criminating items need to be removed.
Summary
The results of this study clearly
point to a revision of the instrument
and further study of the concerns of
primigravida mothers. The addition of
a third group of mothers who receive
skilled public health nursing care
under controlled supervision, plus the
opportunity of rooming-in with their
infants in hospital, is also indicated.
An additional study is the whole area
of "helpfulness"; how a mother in-
terprets help; whom she sees as help-
ful persons; and what they contribute.
References
I. Morris, Marian G. The claiming-identi-
fication processes - their meaning for
mother-child mental health. Amer. J.
Orthopsychiat. 25: 303-4, 1965.
2. World Health Organization. ExperT COIII-
mittel' on Nursing. Technical Report
Series, no. 167. Geneva. 1959.
3. Carpenter, H. et al. An Alwlysi.ç of HOllie
Visits to Newborn Infants. Toronto, East
York Leaside Health Unit, 1960.
4. Hunter, T. et al. Routine home visits to
newborn infants by public health nurses.
Can ad. J. Public Health 53: 371-376.
1962.
5. Mann, D. et al. Educatin{? Expectant
Parents. New York, V.N.A. of New
York, 1961.
6. Martin, G.K. and Ladd, K.B. Maternal
and child services, Ontario, 1958. Canad.
J. Public Health 51: 111-119, 1960.
7. Shyne, A.W. et al. Servin!? the Ma/emit)'
Patient ThrouRh Family-Centered Publir
Health Nursing. New York. Community
Service Society of New York. 1962.
8. Adams, Martha. Early concerns of pri-
migravida mothers regarding infant care
activities. Nurs. Res. 12: 72-77, 1963.
9. Seigel. S. Nonparame/ric Stati.ç/ics For
the Behm';oral Sciences. New York,
McGraw-HilI, 1956. 0
THE CANADIAN NURSE 49
"Project Bed Rest" originated in
June ] 965 during discussion periods
in our medical nursing clinics. As in-
termediate students we were concerned
about the how, when, what, and why
of health teaching. We agreed that
when teaching medical patients our
emphasis should be on both rest and
activity.
First of all we considered the mean-
ing of "rest" and other terms used to
describe rest and activity for patients.
As each of us interpreted "complete
bed rest" and "bed rest," we realized
that there was considerable difference
of opinion regarding what instruction
should be given to patients. Jf a similar
confusion of terms existed in the minds
of doctors, nurses, auxiliary workers,
and patients, how inconsistent the nurs-
ing care must be!
We decided that if guide lines for
teaching medical patients could be es-
tablished, this problem might be solv-
ed. With the help of two of our medical
nursing instructors, we drew up a plan
to study the whole subject of rest, to
define the terms "comp]ete bed rest"
and "bed rest," and to gain approval
of the appropriate groups in the hos-
pitaL Thus, project bed rest was
launched with an overall objective to
provide more consistent nursing care
for medical patients.
The first task was to clarify the
purposes of the project. These were:
]. To provide con!>istent care re-
garding rest and activity throughout the
50 THE CANADIAN NURSE
Project bed rest
Six enterprising students at the Calgary General Hospital School of Nursing
conceived, designed and launched a unique plan to make nursing care for the
medical patient more consistent.
L. Dahl, M. Smith, B. Fowle, J. Hutchison, R. Graham, and D. Black
patient's period of hospitalization.
2. To help the patient understand
his program of care, participate in it
and see his progress.
3. To improve communication
among doctors, nurses, other staff, pa-
tients, and patients' relatives.
4. To aid in the orientation of nurs-
ing students, new graduates, and other
staff.
5. To aid in the teaching of new
nursing students in the nursing arts
program.
The second step in the project was to
define and clarify the terms relating to
rest and activity, namely: ]. complete
bed rest; 2. bed rest; and 3. progres-
sive activity.
Steps 10 obtain approval
To obtain approval for the accept-
ance and implementation of project
bed rest, many steps were involved. At
each level of approval the purposes
and specific definitions of the project
were presented in detail. We empha-
!>ized that staff would not be expected
to adhere rigidly to the definitions but.
rather, that each section could serve as
a guide for all personnel on the health
team. Alterations as specified by the
doctor might be required for individual
patients.
Since the project was initiated by
nursing students, the first step was to
gain the approval of the faculty of
the school of nursing. The plan for
rest and activity was presented at a
faculty meeting. With some minor re-
visions, it was unanimously and en-
thusiastically endorsed. The faculty
suggested that the plan be utilized in
all clinical areas of the hospital.
Next, the revised plan was presented
to the director of nursing service,
supervisors, and head nurses at a staff
meeting. Also present at this meeting
was a consultant cardiologist who had
expressed interest in project bed rest
and had offered helpful suggestions,
especially in defining progressive acti-
vity. Again, the plan was readily ac-
cepted and approved for all clinical
areas.
Having received support from the
faculty and all nursing service person-
nel, we next sought the approval of the
hospital administrator. He reviewed
the plan several times and made some
very helpful suggestions.
The final step was to present the
plan to the medical advisory com-
mittee. The administrator explained the
proposed plan to the committee, and
its members gave us enthusiastic sup-
port and approval.
Implementation
Project bed rest was now ready
to be implemented. The responsibility
for making the plan operational was
accepted by a nursing service commit-
tee under the chairmanship of a head
nurse. The written material was dis-
tributed to all nursing units and to
staff doctors. Individual copies of the
JANUARY 1967
.
- -
.
,.
\
;\
1
-
...
I
-\
,," -!I'
: .f
-- '
,,' J
i
. t
\'
.
particular phase or phases of rest
ordered were given to patients with
verbal explanations. All groups con-
cerned with the project recognized that
the guide lines would have to be inter-
preted to new staff, as well as to in-
coming patients, if project bed rest
were to be successful. 0
\.......
Complete Bed Rest
1. To stay in bed at all times.
Bed Rest
2. a. To be fed.
b. To restrict movements.
I. To stay in bed at all times. except for use of commode
chair.
3. To be bathed every second day or p.r.n. (minimal
linen change)
To have total mouth care after meals.
To have hair shampoo once per week, if ordered, in
bed.
2. To feed self; food must be set up. e.g.. meat cut. bread
buttered, etc.
3. To be bathed. but may wash face, hands and finish
bath.
To remain in bed while linen is changed.
To give self total mouth care after meals.
To have shampoo weekly. if ordered, in bed.
4. To shave self.
To apply own cosmetics.
5. To have half-hour rest periods between 2, 3, and 4
above.
4. To be shaved.
To have cosmetics applied. if desired.
5. To have half-hour rest periods between 2, 3. and 4
above.
6. To be turned q.2h. as tolerated, and raised up in bed
by staff (lifting sheet required, e.g., sheepskin).
7. To have passive movements b.i.d. to all joints for 5
minutes and deep breathing exercises q.lh. (10-12 deep
breaths). Should wiggle toes, fingers, feet, wrists, q. Ih.
8. To have visitors restricted to immediate family (5 min.).
one at a time.
6. To turn self by rolling from side to side like a log;
must be assisted when raising up in bed.
7. fo initiate active movements b.i.d. to all joints, for 5-
minute periods.
To take deep breathing exercises qlh.
8. To have visitors restricted to immediate family (15
min.).
9 To be lifted into commode chair at bedside for bowel
movements.
9. To use bedpan (slipper pan); should be assisted by two
people. Males to use urinal in bed.
10. a. To have reading material propped.
b. To operate radio.
J O. a. To hold books, etc.
b. To operate radio
nd T.V.
J I. To have a "call" light within easy reach at all times.
12. To be checked at regular intervals by the nurse.
I 1. To have a "call" light within easy reach at all times.
12. To be checked at regular intervals by the nurse.
JANUARY 1967
THE CANADIAN NURSE 51
Progressive Activity
Day Bath every 2 days
or p.r.n.
With help. Legs, feet, and
back to be done by nurse
2 With help
3 With help
4 With help
5 With help
6 May bathe self in bed.
Shampoo if ordered.
7 May bathe self in bed.
Shampoo if ordered.
8 May bathe self in bed.
Shampoo if ordered.
9 May bathe self in bed.
Shampoo if ordered.
10 May bathe self in bed.
Shampoo if ordered.
I I Wash self in bath-room.
12 Wash self in bath-room.
Elimination
Commode at bedside for BM's
(lifted).
Use bedpan, urinal for voiding.
Commode at bedside for BM's
(lifted).
Use bedpan, urinal for voiding.
Commode at bedside for BM's
(lifted).
Use bedpan, urinal for voiding.
Commode in BR for BM's, use
bedpan or urinal for voiding.
Commode in BR for BM's, use
bedpan or urinal for voiding.
Commode in BR for everything.
Commode in BR for everything.
May walk to bathroom once
daily.
Commode in bathroom other
times.
May walk to bathroom twice
daily.
Commode other times.
May walk bathroom three times
daily, commode other times.
See "walking."
I
Sitting
,
Walking
Nil
Nil
Nil
Nil
Nil
2 or 3 steps to chair b.i.d. (as-
sisted) .
5 or 6 steps to chair (assisted).
30 min., b.i.d., chair in room. Walk to chair b.Ld. and walk
to bathroom once daily (if
BR within 10 yards of bed).
35 min., b.i.d., chair in room. Walk to bathroom twice daily.
Walk to bathroom three times
daily.
Walk to bathroom four times
daily.
Increase walk to bathroom once
daily then walk in corridor and
up and down stairs as ordered.
52 THE CANADIAN NURSE
JANUARY 1967
Dangle 5 min. b.i.d.
5 min., chair at bedside (lifted).
5 min., b.i.d., chair near bed-
side (self-assisted).
10 min., b.i.d., chair near bed-
side (self-assisted).
15 min., b.Ld., chair near bed-
side (self-assisted).
20 min., b.i.d., chair near bed-
side (see "walking").
25 min., b.i.d., chair in room.
40 min., b.i.d.
45 min., b.i.d.
Increase chair 5 min. daily.
books
Pediatric Nursing by Audrey J. Kalafatich,
R.N., M.S.N. 432 pages. New York.
G.P. Putnam's Sons, 1966,
Reviewed by Miss Nell Joiner, assista1lt
professor, maternal-child nursing, Me-
morial University of Newfoundland
School of NursinR, St. John's, Nfld.
fhe author states in the preface that her
aim is to give some insight into the care
of the "whole child." The format of the
text follows the usual sequence of delineat-
ing care of the child from birth through
adolescence according to developmental
tasks and needs peculiar to specific develop-
mental levels. Throughout the text, brief
reference is made to common diseases and
disorders according to age levels, with treat-
ment and nursing care following each condi-
tion. General principles of nursing care are
outlined but never developed in breadth and
depth.
Unit I is extraordinarily brief and
vague in presenting a frame of reference
for quality nursing care based on un-
derstanding of the child as a person in a
given point of time with a specific problem
and as a member of a family constellation.
The reference to the importance of relation-
ships and interrelationships in pediatrics
follows the same generalization. It would
have been better to omit this entirely rather
than to confuse the issue with superficiality
and vagueness.
Units II through VI deal with the cycle
of childhood from birth through adoles-
cence. The discussions of treatment and nur-
sing care seem more of a condensed resume
with sweeping generalizations, rather than
broad principles upon which to base and
plan individualized nursing care. I find the
discussions that are devoted to nursing care
disappointingly brief and inadequate. An
example of this brevity appears on page
218, where the author devotes a three-
sentence paragraph to the treatment and
care of the infant with cerebral palsy.
Another example of brevity appears on
page 413: "The pre- and postoperative care
that accompanies the spinal fusion will not
be given in detail since it is essentially the
same as for an adult patient with a solid
fusion of the spine." By a swift stroke of a
pen, the author moves to something else
without pointing out the similarities and
differences. It would seem that she is as-
suming that the student has sufficient prior
knowledge and experience to make the
necessary adaptations in planning care for
the adolescent with a spinal fusion.
,ANUARY 1967
Some of the information on treatment
and nursing care is unclear and, consequent-
ly, open to misinterpretation. An example
of lack of clarity appears on page 180 in
whIch the author states that "an elevated
temperature raises the body's need for oxy-
gen and metabolism." Here she treats an
adaptive bodily process, metabolism, in the
same order as the body's need for a life-
sustaining substance, oxygen. What is she
trying to convey - the body's reaction to
an elevated temperature, the increased need
for oxygen to meet the demands of speeded
up cellular activity, or what?
This book falls far short of presenting
any real insight into the care of the "whole
child" and does not support the thesis that
the book is primarily concerned with nur-
sing care. Brevity, sweeping generalizations,
and vagueness are its chief characterictics
and weaknesses. It may have some value
as a handbook for quick, brief references,
but limited value as the text of choice for
basic students in professional nursing.
Fundamentals of Research in Nursing
by David J. Fox, Ph.D. 285 pages. New
York, Appleton-Century-Crofts. 1966.
Reviewed by Miss Kathleen A. Dier, as-
sistant professor, School of Nursing, Un i-
J'ersity of Saskatchewan, Saskatoon,
Saskatchewan.
The stated purpose of this book is to
prepare the nurse to be an "intelligent, criti-
cal consumer of research." The author ex-
plains that the skills needed to understand
and use research are different than those
needed to do research. It is intended to
help nurses evaluate the research now being
produced. not only in nursing but in relat-
ed social sciences as well. Dr. Fox is well
prepared for this assignment as he teaches
an introductory course in nursing research
at Columbia University, New York.
The book is divided into five major areas.
The author begins by describing a project
that he conducted, then deals in detail
with the 17 steps required in the planning
and implementing of this study. He proposes
a model that should help identify areas for
further research in nursing. It is stated that
nurses have a unique contribution to make,
providing they concentrate on problems
related to nursing. However, Dr. Fox is
also in favor of interdisciplinary research
where the nurse is a member of the investi-
gating team.
The second area is mainly devoted to
statistical procedures that the author believes
must be comprehended before the principles
of research can be understood. The rationale
of statistics is given without any of the com-
plicated formulae. Even though this section
is clearly written with practical examples
taken from nursing, some of the concepts
might be hard to grasp if the reader has
no previous knowledge of statistical
methods. The section on sampling is excel-
lent.
The fourth area deals with the various
types of research and the methods of
gathering data. Here, the issue of ethics
in nursing research is raised and I would
heartily agree that this is a problem that
must be faced soon by our profession.
In the fifth section, the nurse is advised
how to evaluate the written report. It is
truly stated that where research is concerned
nurses have been "a polite, uncritical and
largely unresponsive audience." Dr. Fox
urges nurses to make more use of good
research findings and actively reject those
that are poor. This is the only way that the
product will be improved.
I believe the author has achieved his
objective by presenting rather complex
research methodology in a simple, straight-
forward manner. It could be a valuable
reference for leaders in nursing and students
in university, since it contains many ideas
for nursing studies and an excellent reading
list. Although it is not light reading, I
would recommend this book to all nurses
who wish to become intelligent participators
in the changes now taking place in our pro-
fession.
Basic Concepts in Anatomy and Physiology
by Catherine Parker Anthony, R.N., B.A.,
M.S. 132 pages. Saint Louis, Mosby, 1966.
Rn'iewed by !'vlrs. Jean Magee, instructor
of anatomy and physiology, Victoria
General Hospital School of Nursing,
Halifax, Nova Scotia.
To review this book objectively, I had to
supplement my knowledge of programmed
instruction. In so doing, I reversed a rather
unfavorable first opinion to one of great
enthusiasm.
The author has achieved her expressed
purpose to produce a programmed text that
would be used as a "supplement and not
as a substitute for a conventional textbook."
She states in the preface that "the book
will have greatest value for students wanting
10 acquire or review basic information or to
(Continued on page 54)
THE CANADIAN NURSE 53
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Personnel Office, Dept. 401
Mary Fletcher Hospital Medical Center I
Burlington, Vermont 05401 I
Please tell me more about career opportuni- I
ties at Mary Fletcher Hospital Medical Center I
and send me literature about Vermont - I
The Beckoning Country. I
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NAME I
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-------------------
IN CAPS AND GOWNS
THE STORY OF
THE SCHOOL FOR
GRADUATE NURSES
McGill UNIVERSITY
1920 - 1964
. . provides vignettes of the devoted
and far-seeing women who toiled to
develop the School ... An amazing
feature of this book is the warm and
engaging style which emerges ... A
handsomely produced volume."
THE MONTREAL STAR
A vailable by mail or in person
c/o
SCHOOL FOR GRADUATE NURSES
3506 University Street
Montreal r P.Q.
PRICE: $6.50 per copy
54 THE CANADIAN NURSE
books
(Co/ltinued from page 53j
clarify difficult concepts about the human
body."
Information in sequence is presented in
small steps (frames) that require frequent
responses by the student. Miss Anthony
chose to use the classical linear form type
of frame developed by Skinner at Harvard
University, rather than the branching or
multiple-choice frame. Early frames in each
unit set forth simple, easy concepts of the
subject material.
If the reader chose only to read the begin-
ning questions in each unit, she would
probably conclude that the entire book was
too elementary for students of nursing.
Questions in the early frames tend to be
redefinitions of what has been previously
stated, and a simple glance upward supplies
the missing word. However, as the frames
progress, there is also a step-by-step progres-
sion in the complexity of subject matter.
The reader finds herself actively reading
and responding to highly complex concepts
without realizing their complexity.
In this text, immediate feedback is given
to the student to inform her whether her
response is correct. The student need waste
little time and effort confirming her res-
ponses as the correct answer is found to
the left of each frame. Thus, if she answers
correctly, she progresses to the next fact.
If she does not understand, she can be
helped immediately.
In summary, this book will be a chal-
lenge to those who teach anatomy and
physiology in schools of nursing. It could
prove helpful as an aid to all students, in
particular, to those students who have dif-
ficulty grasping principles in this subject.
.............. ..............
..............
SPEND 12 MONTHS IN ENGLAND. . . ..
.. A POST ..
REGISTRA TION
COURSE
leading to the
OPHTHALMIC NURSING DIPLOMA
at
MANCHESTER ROYAL EYE HOSPITAL
An interesting course at Britain'. largest pro.
inciol Eve Hospilol, porI of fhe greol Teoch-
Ing HOSpllol ossocioled wilh Ihe UniversilV of
Manchester.
Requirements - Reciprocal registration with
Ihe Generol Nursing Council for Englond ond
Woles.
Salary [57.10.. Slerling
er manlh
5 weeks holiday wil pay
Attractive accommodation approx. f19
Slerling per month
Wrile for further deloils 10: Miss N Muslord
B.N. McGill, Molron, Monchester Rovol EY
.. Hospilol, Manchesler 13, Englond.
..
Elementary Textbook of Anatomy and Phys-
iology Applied to Nursing by Janet T.E.
Riddle, R.G.N., R.F.N., O.N.C. 151
pages. Toronto, MacMillan of Canada,
1966.
Reviewed by Sister Frances L. Rooney,
assistant administrator, Holy Family Hos-
pital, Prince Albert, Sask.
In spite of the brevity of this text, es-
ecially in the content about physiology, it
tS a very practical presentation, and should
be of particular value to nursing assistants
and technicians. Each system is presented
concisely, and the book concludes with a
valuable chapter on "Posture - Nurse and
Patient. "
The chapter on the digestive system is
incomplete, but the chapter on the respir-
atory system is excellent. Accompanying
illustrations are good. Anyone studying
anatomy and physiology will find the review
questions at the end of each chapter very
practical, especially in reference to an-
atomy.
This book is, as the author states "a
simple overall picture of the human b
dY"
and as such should be of value to a nurse
looking for a quick review, or the beginning
student who requires only very elementary
knowledge of the subject.
In Caps and Gowns by Barbara Logan
Tunis, B.N. 154 pages. 1966. Montreal,
McGill University Press.
Reviewed by Miss Margaret E. Kerr, Apt.
1403, 150 -24th Street, West Val/couver,
B.C., formerly executive director and
editor of The Canadian Nurse.
The significance and importance of uni-
versity education for professional nurses has
been so strongly emphasized over the past
few years that it is difficult to realize that
50 years ago, even 40 years, it was practi-
cally an unknown quantity in Canada. Grad-
uates of the past two or three decades
scarcely can imagine a time when Canadian
universities. through their Boards of Gover-
nors, flatly refused to recognize the desire
or the need for any programs for nurses.
Today, the strong emphasis on advanced
preparation is a keystone of policy in the
Canadian Nurses' Association. The findings
of the Royal Commission on Health strength-
en the CNA platform. Why was nursing
for so long an unwanted stepchild of higher
education?
This question and many others of a simi-
lar nature are answered in this history of
the development of the School for Graduate
Nurses of McGill University. Out of her
very thorough research of old records. her
interviews and correspondence, and her per-
sonal knowledge as a member of the first
class to receive a B.N. degree from Mc-
Gill. Mrs. Tunis has woven a wondrously
interesting history that merits the attention
of today's generation of nurses.
The close of World War I marked a
JANUARY 1967
books
turning point in medical care. The change
of emphasis from strictly curative to broad-
ly preventive program
brought with it a
growing demand for nurses who were quali-
fied to go into the homes. the schools, and
industries to teach the fundamentals of good
health. Preparation for these new duties was
not included in the curricula of many of
the "training schools" of that day. It seemed
logical, therefore, that the leaders in nurs-
ing should turn to the traditional sources
of higher education - the universities -
for guidance and assistance in developing
the essential cour
es. Unhappily, organized
nursing had not yet set its own educational
tandards either for admission to schools
or for the programs of instruction provided.
Thus, it was inevitable that there should be
difficulties in persuading universities of the
validity of the requests for a place to be
found within the university for nursing
programs.
That the original committee of nursing
leaders in Montreal was able to achieve an
initial goal by 1920 is a tribute to their
dogged perseverence. With three different
certificate courses established, student en-
rollment flourished. Financially, there were
always problems to maintain the School, so
the sharp depression of the thirties came as
a shuddering, almost fatal blow.
It was then that the active Alumnae As-
sociation, by a herculean effort, with Miss
E. Frances Upton leading the way, raised
the necessary funds.
Throughout her history, Mrs. Tunis has
given us many intimate biographical sketches
of the people who have brought the School
to its present stature. For these alone, In
Caps and Gowns is worthy of interested
reading. Through them she has portrayed
not only their contributions to the School
for Graduate Nurses but also an insight into
the development of our own Canadian
Nurses' Association.
We strongly recommend this history to
instructors in our schools of nursing, to
graduate nurses everywhere, and of course
to those nurses who have been privileged
to participate in any of the programs of
study that are provided.
Annototed Bibliogrophy on Childhood
Schizophrenia 1955-1964 by James R.
Tilton, M.S., Marian K. DeMyer, M.D.,
and Lois Hendrickson Loew, M.S. 136
pages. Toronto, Ryerson, 1966.
Re
'iewed by Mrs. E.M. Pollard, nursing
administrator, Sherwood Hospital, Char-
lottetown, P.E.I.
rhe object of the authors has been to
provide a comprehensive SOurce of reference
to the English-language writings on child-
JANUARY 1967
hood schizophrenia for the period 1955 to
1964.
The book is subdivided appropriately into
seven sections: historical and general review
articles; descriptions and diagnosis; etiology;
biochemical, neurological, and physiological
studies; family characteristics; treatment and
care; and follow-up studies. In each section
the annotations of the books and papers are
concise and clear-cut.
This bibliography should save many hours
of searching through library shelves, as the
books and periodicals listed are readily
available in the libraries of psychiatric
units. The objective of the authors has been
accomplished.
films
Pharmacology
Drugs and the Nervous System is a
recently-released film showing the effects
of drugs on organs and body systems.
Aspirin is used to demonstrate how a drug
works, but considerable emphasis is placed
on the abuse or misuse of certain drugs,
such as stimulants (amphetamines), depres-
sants (barbiturates, opiates), and halluci-
nogens (marijuana. LSD).
The film is in color and runs for 16
minutes. FuU information can be obtained
from Churchill Films. Educational Film
Distributors Ltd., 191 Eglinton Ave. E.,
Toronto 12, Ontario. A rental fee is charged.
Cardiac arrest
The Nurse in Emergency Cardiopulmonary
Resuscitation, a 16 mm., 15 minute, color,
sound film, was released in faU 1966. It
shows a hospital patient in acute cardio-
pulmonary distress and emphasizes the
nurse's function and responsibilities from
the initiation of resuscitation through to
transfer of the patient to the care of the
physician.
The film would be especially useful in
inservice education programs, and for show-
ing in schools of nursing. It is available on
loan from the Canadian Heart Foundation.
1130 Bay Street, Toronto 5, Ont.
Arthritis
Rheumatoid Arthritis is a new, 30-minute,
color, sound film designed primarily for the
physician. However, it contains considerable
information on aspects of this complex
disease process that would be of considerable
interest to student nurses and to graduate
nurses working with patients suffering from
these diseases.
Etiology, diagnostic methods, and recent
advances in treatment are demonstrated.
Typical arthritic forms in the adult are
shown and the development from monar-
thritis to polyarthritis.
The film may be borrowed from Film
Library, Pfizer Company Ltd., 50 Place
Cremazie, Montreal II, Quebec.
Next Month
in
The
Canadian
Nurse
Estrogens
and the
menopause
Care of
patients
with
skin cancer
Drug addiction
- research,
treatment, and
nursing care
Photo credits
Dominion-Wide, p. 8.
Cerebral Palsy Assoc. of
Quebec, p. 31.
National Hcalth and Welfare,
pp. 44, 51.
Miller Services, Toronto, p. 47.
THE CANADIAN NURSE 55
'\
ORKSIIOPS FOR
DIRECTORS AND
i\.SSIST ANT DIRECTORS
SiK regionol workshops for directors or ossistant directors of nursing service in hospitals
will be conducted in 1967. The topic: Improvement of Nursing Service in Hospitals Through
the problem-Solving Method.
The workshops aim at stimuloting directors and assistant directors of nursing service to use
the problem-solving approach in the odministrotion of nursing services. Key speakers will
discuss techniques of problem-solving. Major problems in nursing services in Canada will be
discussed. Through group work and case study methods skills in problem-solving will be
developed.
Two workshops will be
Region
Atlantic
West
And four In the Fall:
Region
Ontario
Mid-West
Ontario
Quebec
held in the Spring:
City
HalifaK
Vancouver
Dote
April 11-14, 1967
May 2.5, 1967
City
Toronto
Regina
London
Quebec City
Dote
October 17-20, 1967
October 24-27, 1967
November 7-10, 1967
Nov. 28-Dec. 1, 1967
EKact locations will be onnounced later.
The workshop to be held in Quebec city will be conducted in the French language only.
English longuage nurses in the province of Quebec ore invited to ottend one of the work-
shops held in Ontorio. French language nurses in New Brunswick are invited to attend the
workshop in Quebec city.
The workshops are open to directors or assistant directors of nursing service in hospitals.
Registration is limited to 60 persons. The registration fee is $50.00. Because of the nature
of the workshop only full-time registrants can be accepted.
Here is an opportunity for directors and assistant directors of nursing service:
. to sharpen skills in problem-solving within a
"training laboratory" environment;
. to leorn how problem-solving can be facilitated through group work;
. to stimulate orderly thinking toward the improvement of
nursing service;
. to identify the leadership role of the director of nursing service
and/or assistant director of nursing service in problem-solving and
decision making.
Interested! then plan now to attend the workshop in your area. Register early and avoid
disappointment.
I wish to register for the CNA Regional Workshop for Directors or
Assistant Directors of Nursing Service in Hospitals held in :
o Halifax 0 Regina
o Vancouver 0 London
o Toronto 0 Quebec City
Name
Title of Position
Name of Hospital
City or Town
Qualifications beyond RN
I enclose postal note (bank money order) for $
payable to the Canadian Nurses' Association.
Years in Position
Number of Beds
MAIL TO:
CANADIAN NURSES' ASSOCIATION
50 The Driveway
Ottawa 4, Ontario
56
THE CANADIAN NURSE
accession list
Publication
in this list of material
received recently in the CNA library are
\hown in I,mguage of source. The majority
(reference material and theses. indicated by
R excepted) may be borrowed by CNA
member
. and by libraries of ho\pitals and
\choo]
of nursing and other institutions.
Requests for loan\ should be made on the
"Reque\t Form for Accc\\ion Li\t" (page
58) and should be addre
sed to: The Li-
brary. Canadian Nurses' Associ,nion. SO
The Driveway. Ottawa 4. Ontario.
BOOKS AND DOCUMENTS
I. Basic COllceptS ill lIlIatomy alld phy-
\'/ology by Catherine Parker Anthony. St.
Louis. Mosby. 1966. 133 p.
2. Bibliograp/'ical procedures alld style by
Hlanche Pritchard McCrum and Helen Du-
denbostel Jones. Washington. Library of
Congress, 1954. ] 33 p.
3. Calladiall quotatiolls ami phra.res, liter-
ary alld historical by Robert M. Hamilton.
Toronto. McClelland and Stewart. ] 952.
272 p. R
4. Cvmmullity colleges ill Callada, Na-
tion,.1 seminar on The Community College
in Canada. May 30, 31. June I. 1966. To-
ronto, Canadian Association for Adult Edu-
cation, 1966. 109 p.
5. Colltilluity of patiellt care: the role of
lIunillg by K. Mary Str,lUb and Kitty S
Parker. Washington. Catholic Univer
ity of
American Press. c] 966. 232 p.
Ii. The dc.\criptÏ1'e catalogillg vf library
mCllaials, 2d ed. rev., by Shirley L Hop-
kin
on. S,m Jose. Calif., Claremont House,
c1966. 78 p.
7. Ecollomic comequellces of the profes-
rioll.f by D.S. Lees. London. Institute of
Economic affairs. 1966. 48 p.
8. Education studies in progress in Can-
adian //IIi\'ersilies 1965 by the Canadian
Education Association Research and Infor-
mation Division. Toronto. 1966. 210 p. R
9. Essentials of chemistry by Gretchen O.
Luros and Jack C. Towne. Philadelphia.
Lippincott. c1966. 356 p.
01'10. The foundations of nursing as cvn-
ceil'ed, learl/ed, and practiced in profes-
.fiol/al I/ursil/g by Lillian DeYoung. SI.
Louis, Mosby, 1966. 279 p.
I I. FUI/damentais of public health I/ursing
by Kathleen M. Leahy and M. Marguerite
Cobb. New York. McGraw-Hili. c1960. 225 p.
12. Group psychotherapy in nurs/llg prac-
tice by Shirley W. Armstrong and Sheila
Rouslin. New York. MacMillan. c1963. 170 p.
13. l.fSue.f i/l /lursil/g by Bonnie Bullough
and Vern Bullough. New York. Springer.
c1966. 278 p.
14. The leader and the prOCe.fS of change
by Thoma
R. Bennett, New York. A\
oci,l-
tion Pre
s, c1962. 63 p.
15. The life of Florel/ce Nigl1tingale by
Sarah A. Tooley. New York. MacMillan.
JANUARY 1967
accession list
london. Bousfield. 1905. 344 p.
16. !llaterni1\' care ill the wurld: mterna-
tional survey of mid\\-ifery practice and
training. Report of ,I Joint Study Group
of the International Federation of Gynae-
cology and Ob
tetrics and the International
Confederation of Midwive
. Oxford. Perga-
mon Pre
s. c 1966. 527 p.
17. No mall stallds alolle by Amy V. Wil-
,on. Sidney. B.C'.. Gray. 1966. c1965. 138 p.
18. Nllr.fe ph\'siciall collaboratioll toward
Ùllpl'ol'ed patiellt care. Papers from National
Conference for Professional Nur
e
and Phy-
sicians. 2d. Denver. Col., Sept. 3D-Oct. 2.
1965. sponsored by The American Medical
A
ociation and The American Nur
ð As-
sociation. New York. American Nurses As-
sociation. c 1966. 63 p.
19. N ur.fÏllg care plalls. Study program in
nursing management by the American Ho
-
pital Association. Hospital Research and
Education Trust. Chicago. American Hos-
pital Association. 1966. 77 p.
. 20. The lIursillg prufeHioll: fil'e mciol-
ogical essays by Fred Davis. New York.
Wiley. c1966. 203 p.
21. The lIursillg senice mallual of policies
alld wor/..illg relatiolls 3d ed. prepared by
St. Francis Hospital. Wichit:!. Kansas. St.
loui
. Catholic Ho'pital Association. 1964.
Iv.
22. Opilli01/f de sept groupes de perSUlllles
ell COli tact al'ec l'C'tudiaute illfirmière par
rapport a des comportement, généralement
dé,irables ou inacceptable, par Soeur Jeanne
Fore
t. Montréal. 1966. Thesis - Olla\\-a R
23. Piuurc: \OlIri es. 2d ed.. by Cele
tine
G. Frankenberg. New York. Special Librarie
A
sociation. c 1964 216 p. R
2
. A 1'1011 for imlerillg the periudical
literature of lIursillg by Vern M. Pings. New
York, American Nur
es' Foundation, c1966.
:!02 p.
25. Proce.';illg ma/1//(/I: a pictori,tI work-
book of cat,llo
cards by Althea Conley
Herald. Teaneck. New Jersey. Fairleigh Di::-
kinson University Pre
s. 1963. 88 p.
26. Relwhilitatioll cellter pl(lllllillf! (III or.
chitectural guide by Cuthbert A. Salmon and
Christine F. Salmon. University Park. Penn..
Pennsylvania State University Press. 1959.
1964 p.
27. Studellt Ilune I,'a,'tage by General
Nursing Council for England and Wales.
London. 1966. 48 p.
28. A stlldv of programs ill selected
fe/IOOls of lIursillf! to determille the liberal
edllcatioll coutellt of the curriculum with
specific referellce to learnillg experiellces
related to lIursill!! of the af!ed by Frances
Edith Bell. London. 1966. 175 p. Thesis
(M.Sc.N.) - We
tern Ontario R
29. A study of the relatiollship betweell
tI,e predictioll of succefS ill a school of
lIursillg alld c1illical performallce by Jeanne
Dolores Zelech. Se,lItle. 1966. 87 p. Thesis
(M.N.) - Washington. R
30. Ta/..ill!! the hospital to the patieut;
home care fur the small COllllllllllity by John
R. Griffith. BailIe Creek. Mich.. W.K. Kel-
logg Foundation, 1966. 55 p.
31. Teachillg alld Admillistratioll ill Nurs-
in!! Associate Degree Prograllls. Second
Seminar. Purdue University. July 18-30.
1965. Report. Layfelle. Indiana. Purdue
Univer,ity, Dept. of Nursing, 1965. 49 p.
32. TeHboo/.. of allatomy Gild phyÛology
for Ilunes by Diana Clifford Kimber and
Carolyn E. Gray. 5th ed. rev. New York.
MacMillan. 1919. 527 p.
33. Todav alld tomorrow ill we.'terfl flllrs-
ÙI!! by Western Interstate Commission for
Higher Education. Bolder. CoI.. 1966. 108 p.
PAMPHLETS
4. ApprOl'ed medical-Illlne plocedllres
by Registered Nurses' As
ociation of Nova
Scotia. Halifax. 1966.
35. A guide for staff educatioll alld staff
dl'l'elopmellt by the Regi
tered Nur<;cs Asso-
ciation of Ontario. Commillee on Nur
ing
Service. Toronto. 1966. 6 p.
36. A guide to iuterl'iewillg alld cuulHeI-
illg for the lIurse ill illdustry by the American
Association of Industrial Nurses. Committee
\r
tur (f JlOrectfl!
rOll/lort
thflt {fistS!
meet the patient's needs with
ANUSOL
Hemorrhoidal Suppositories and Ointment
SAFE: Anusol contains no
analgesics or narcotics and will
not mask the symptoms of serious
rectal pathology.
'r
\
..
(
I
CHASE
HOSPITAL
DOLLS
For demonstrating and practicing the
newest nursing techniques . lavage and
gavage . tracheotomy and colostomy,
and their post-operation care . nasal
and otic irrigations . catheterization and
all abdominal irrigations . subcutane-
ous, intramuscular and intradermal injec-
tions . and all standard nursing procedures.
Let us tell you about the new features we
have added to this world-famous teaching
aid. Write to
M. J. CHASE Co. Inc.
Pawtucket
.
-
WARNER-CHILCOTT I EÐ I
laboratories Co. limited, Toronto, Canada we
Makers of Tedral.Brondecon, Choledyl
JANUARY 1967
156 Broadway
Rhode Island
THE CANADIAN NURSE 57
accession list
on Education. New York. American Asso-
ciation of Industrial Nurses. 1960. p. 21-28.
(Reprint) R
37. A guide to till' respullsibilities alld
qualificatiolls for mriulls positiufl.f ill IIl1rs-
illg .fenice by the Registered Nurses Asso-
ciation of Ontario. Committee on Nursing
Education Sub-Committee on Basic Oegree
Programs. Toronto, 1966. 2 p.
38. A gllide to tile respollsibilities and
qualificationf for "uriolls positions in nllrs-
ing .ferl'ice by the Registered Nurses Asso-
ciation of Ontario. Committee on Nursing
Service. Toronto. 1966. 8 p.
39. How to IIse YOllr lihrary by Harold
S. Sharp. New York. Consolidated Book
Service. c1963. 17 p.
40. Preselllatioll 011 nllrsing needs for
Prince Edward Island. Brief to the execu-
tive council of the Prince Edward Island
Government by the Association of Nurses of
Prince Edward Island. Charlottetown, 1966.
10 p.
41. A teacllillg guide to science and cancer
by Ralph P. Frasier and others for the
National Science Teachers Association.
Washington. U.S. Oept. of Health. Educa-
tion and Welfare. Public Health Service.
1966. 24 p.
42. T eaclltllg melltal IIealtll in tire basic
uursing program by the Registered Nurses
Assocication of Ontario. Committee on Nurs-
ing Education. Toronto, 1966. 10 p.
GOVERNMENT DOCUMENTS
Canada
43. Illternal migratioll ill Callada, 1921-
1961 by Isabel B. Anderson. Ottawa, Eco-
nomic Council of Canada, 1966. 90 p.
44. Assllrallce médicale pril'ée et paiement
par alllicipatioll par Charles H. Berry. Ot-
tawa, Imprimeur de la Reine, 1966. 255 p.
(Commission royale d'enquête sur les ser-
vices de santé.)
45. Tile cOlllributioll of edllcation to eco-
nomic growtll by Gordon W. Bertram.
Ottawa, Economic Council of Canada, 1966.
150 p.
SasJ..atcllewall
46. Oept. of Public Health. Ad hoc Com-
mittee on Nursing Education. Report. Re-
gina, Queen's Printer, 1966. 226 p.
United States
47. Bibliographic aspects of medlars by
Seymour I. Taine. Washington, U.S. Public
Health Service; Reprint from Bull. Med. Lib.
Assoc. v. 52, no. I, Jan. 1964. p. 152-/57.
48. Dept. of Health, Education and Wel-
fare. Public Health Service. Focus resources
ill school health services. Washington, U.S.
Govt. Print. Off., 1966. 20 p.
49. Dept. of Health, Education and Wel-
fare. Public Health Service. Health mall-
power source book, sectioll 2, Nursing per-
sOllllel. Washington. U.S. Govt. Print. Off.,
1966. 113 p.
50. Oept. of Health, Education and Wel-
fare. Public Health Service. How to be a
nurses' aide ill a nursing home; instructor's
mallual. Washington, U.S. Govt. Print. Off.,
I 966. 20 p.
51. Oept. of Health. Education and Wel-
fare. Public Health Service. Occupational
melllal IIealth: all emerging art. Washington,
U.S. Govt. Print. Off.. 1966. p. 961-976.
52. Oept. of Health, Education and Wel-
fare. Public Health Service. Pllblic Health
service film catalog 1966. Washington, U.S.
Govt. Print Off.. 1966. 99 p.
53. Oept. of Health, Education and Wel-
fare. Public Health Service. Traillillg pro-
f!rams of the Natiullal ll1stitttte of Melltal
Health. Washington, U.S. Govt. Print. Off.,
1966. 21 p.
54. Desigll features affectillg asepsis ill
tile hospital by Richard P. Gaulin. Rev.
Washington, U.S. Oept. of Health, Edcation
and Welfare. Public Health Service. 1966.
10 p.
55. National Library of Medicine. Cllm-
ulated index medicus, 1965. Washington,
U.S. Govt. Print. Off.. 1966. 4 pts. R
56. Occupatiollal health IIl1nes: all initial
slln'ey by Mary Lou Bauer and Mary
Louise Brown. Washington, U.S. Oep!. of
Health, Education and Welfare. Public
Health Service, 1966. 146 p.
Request Form for "Accession List"
CANADIAN NURSES' ASSOCIATION LIBRARY
Send to:
LIBRARIAN, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario.
Please lend me the following publications, listed in the
Canadian Nurse, or add my name to the waiting list to receive them when available:
Item
No.
Author
issue of The
Short title (for identification)
Requests for loans will be filled in order of receipt.
Reference and restricted material must be used in the CNA library.
Borrower
Position ..
Address
Date requested
58 THE CANADIAN NURSE
JANUARY 1967
classified advertisements
ALBERTA
BRITISH COLUMBIA
Regi.t.r.d Nur... (2-required immediately) far 20-bed,
8 bassinet. active treatment hospital. Location. South-
ern Alberta. Starting salary $370 with annual in-
crement. to $420. recognition given for Qualifications
and experience. 28 days vacation plus 9 statutory
holidays. Board and room available in modern
nurses' residence. Medical Insurance and Pension
Plans available. Apply to: The Matron, or Adminis-
trator, Bow Island General Hospital, Bow Island,
Alberta. 1.11-2
R.gist.r.d Nu.... for new 50-bed active treatment
hospital situated only 15 miles from Edmonton.
Salary $360 - $420 per month. Recognition given for
previo\JI experience. Excellent personnel policies and
working conditions. For further information please
write to: Miss M. Macintosh, R.N., Director of
Nursing, Fort Saskatchewan General Hospital, Box
1270, Fort Saskatchewan, Alberta. 1.39-2
Regi.t.r.d Nurse. WANTED (immediate vacancies)
34-bed active treatment hospifar, fuliV accredited,
located in prosperous farming district in central
Alberta. Salary range $360 - $420 with experience
recognized. AO hour week - 21 days annual vacation
plus statutory holidays, with rotating 8 hour shifts.
Full maintenance in nurses' residence $35 per month.
For further information kindly contact: Mrs. M. Carter,
Director of Nursing, Provost Municipal Hospital. Pro-
vost, Alberta. t.73-1
REGISTERED NURSES FOR GENERAL DUTY (WANTED)
for a 37.bed General Hospital. Salary $380 - $440
per month. Commencing with $375 with I year and
$390 with 3 years practical experience elsewhere.
Full maintenance available at $35 per month. Pen-
sion plan available, train fare from any point in
Canada will be refunded after t vear employment.
Hospital located in a town of 1,100 population, 85
miles from Capital City on a paved highway.
Apply to: Two Hills Municipal Hospital, Two Hills,
Alberta. t-88-1
ADVERTISING
RA TES
FOR ALL
CLASSIFIED ADVERTISING
$10.00 for 6 lines or less
$2.00 for each additional line
Rates for display
advertisements on reQuest
Closing date for copy and cancellation is
6 weeks prior to 1st day of publication
month.
The Canadian Nurses' Association has
not yet reviewed the personnel policies
of the hospitals and agencies advertising
in the Journal. For authentic information,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which they are interesteQ
in working.
Address correspondence to:
The
Canadian ð
Nurse Ç7
50 THE DRIVEWAY
OTTAWA 4, ONTARIO
JANUARY 1967
I I
ALBERTA
NURSES FOR GENERAL DUTY in active 30-bed hospital,
recently constructed building. Town on main line of
the C.P.R. and on Number 1 highway, midway
between the cities of Calgary and Medicine Hat.
Nurses on staff must be willing and able to take re-
sponsibility in all departments of nursing, with the
exceptions of the Operating Room. Recently renovated
nurses' residence with all single rooms situated on
ho.pital grounds. Apply to: Mrs. M. Hislop, Adminis-
trator and Director of Nursing, Baslano General Hos-
pital, BOlsano, Alberta. 1-5-1
General Duty Nur.e. (2) for active treatment hospital
15 beds; 2 Doctors, minimum monthly salary $355
commensurate with experience. Extra pay for even-
ings and nights. Fare refunded after 2 years satisfac-
tory service. Apply giving experience and references
to: Matron Administrator, Box 98, Bonnyville, Alberta.
1-10.3 B
General Duty Nurlel for an active accredited well
equipped 64-bed hospital in a growing town, popu-
lation 3,500. Centrally located between maior cities.
Full maintenance available in a new residence, $35.00
per month. Alberta Registered Nurses salary $360.00
- $420.00, commensurate with experience. Excellent
personnel policies and working conditions. Apply:
Director of Nursing, Brooks General Hospital, Brooks,
Alberta. 1-13-1 A
GENeRAL DUTY NURSES - .alary range $4,140 to
$4,980 per annum. 40 hour work week, modern liv-
ing-in facilities available at moderate rates, if de-
sired. Civil Service holiday, side. 'eave und pension
benefits. Apply to: Baker Memorial Sanatorium, De-
partment of Public Health, Calgary, Alberta. 1-14-3
GENERAL DUTY NURSES for modern 25-bed hos-
pital on Highway No. 12, East-Central Alberta.
Salary range $380 to $440. (including a regional
differential). New staff residence. Full maintenance
$35. Personnel policies as per AARN. Apply to the:
Director of Nursing, Coronation Municipal Hospital,
Coronation, Alberta. Tel.: 578-3803. 1-25.IB
GENERAL DUTY NURSES for 64-bed, active treatment
haspital, 35 miles South of Calgary. Salary range
$360 - $420. Living accommodation available in
leparate residence if desired
Full maintenance in
residence $35 per month. 30 day. paid vacation after
12 months employment. Please appl y to: The Director
of Nursing, High River Municipa Hospital, High
River, Alberta. 1-46-1
GENERAL DUTY NURSES: Modern 26-bed hospital
close to Edmonton. 3 buses daily. Salary $360.00 to
$420.00 per month commensurate with experience.
Residence available $35.00 per month. Excellent
personnel policies. Apply: Director of Nursing,
Mayerthorpe Municipal Haspital, Mayerthorpe, Al-
berta. 1-61-1
GENERAL DUTY NURSES for 94-bed General Hospital
located in Alberta's unique Dinasaur Badlands. $360
- $420 per month, 40 hour week, 3t days vacation,
pension, Blue Cross, M.S.I. and generous sick time.
Apply to: Miss M. Hawke., Director of Nursing, Drum-
heller General Hospital, Drumheller, Alberta. 1-31-2 A
General Duty Nurse for madern 50-bed active hos-
pita' in Central Alberto, Highway No.2. Basic salary
$360 - $420, 40 hour week, pension plans and group
Blue Cross. Full maintenance $35 available. Apply
to: Administrator, Ponoka General Hospital, Box 699,
Ponoka, Alberta. 1-72-3
GENERAL DUTY NURSES (6) and CERTIFIED NURS-
ING AIDES for modern 72.bed hospital. Salary $355
and $240 respectively; credit for experience; liberal
palicies. Accommodation available. Apply to: Ad-
ministrator, Providence Hospital, High Prairie, AI.
berta. 1.45-1
Operating Roam Nurse for new 30-bed hospital,
active in surgery. Four doctors on medical staff.
Salary Commensurate with training and experience.
Hospital located 20 miles west of Edmonton. Apply
to: Director of Nursing, Stony Plain Municipal Hos.
pital, Stony Plain, Alberta. t-99-1
BRITISH COLUMBIA
Royal Jubilee Hospital, Victoria, B.C., invites B.C.
Regi.t.red Nur.e. (ar tha.e eligible) to apply for
positions in Medicine, Surgery and Psychiatry. Apply
to: Director of Nursing. Victoria, British Columbia.
2-76-4A
I I
Operating Raam Hood Nurse ($464 - $552), General
Duty Nurs.. (B.C. Regist.red $405 - $481, non-Regis-
tered $390) for fully accredited 113-bed hospital in
N.W. B.C. Excellent fishing, skiing, skating, curling
and bowling. Hot springs swimming nearby. Nurses'
residence, room $20 per month. Cafeteria meals.
Apply: Director of Nursing, Kitimat General Hospital,
Kitimat, British Columbia. 2-36- 1
B.C. R.N. far General Duty in 32 bed General Hospi-
tal. RNABC 1967 salary rate $390 - $466 and fringe
benefits, modern, comfortable, nurses' residence in
attractive community close to Vancouver, B.C. For
application form write: Director of Nursing, Fraser
Canyon Hospital, R.R. I, Hope, B.e. 2-30- 1
GENERAL DUTY NURSES (Twa) for active 66-bed
hospital, with new hospital to open in 1968.
Active In-service programme. Salary range $372 to
$444 per month. Personnel policies according to
current RNABC contract. Hospital situated in beauti-
ful East Kootenays of British Columbia, with swim.
ming, golfing and skiing facilities readily available.
Apply to: The Director of Nursing, St. Eugene Hos-
pital, Cranbraok, British Columbia. 2-15-1
General Duty Nurses for well-equipped 80-bed Gener-
al Hospital in beautiful inland Valley adiacent Lake
V.athlyn and Hudson Bay Glacier. Initial salary $387.
Maintenance $60, AO-hour 5 day week, vacation with
pay, comfortable, attractive nurses' residence,
Boating, fishing, swimming, golfing, curling, skating,
skiing. Apply to: Director of Nursing, Bulkley Valley
District Hospital, P.O. Box No. 370, Smithers, British
Columbia. 2-67-1
General Duty Nurse. (2 immediately) for active,
26-bed hospitol in the heart of the Rocky Mountains,
90 miles Irom Banff and Lake Louise. Accommoda-
tion available in attractive nurses' residence. Apply
giving full details of training, experience, etc. to:
Administrator, Windermere District Hospital, Inver-
mere, British Columbia. 2-31-1
General Duty Nurses for new 30.bed hospital
located in excellent recreational area. Salary and
personnel pol icies in accardance with RNABe. Com.
fortable Nurses' home. Apply: Director of Nursing,
Boundary Hospital, Grand Fork., British Columbia.
2-27-2
General Duty Nurse. for active 30.bed hospital.
RNABC policies and schedules in effect, also North-
ern allowance. Accommodations available in res-
idence. Apply: Director of Nursing, General Hospital,
Fort Nelson, British Columbia. 2-23-1
General Duty O. R. and experienced Obstetrical
Nur.e. for modern, ISO-bed hospital located in the
beautiful Fraser Valley. Personnel policies in ac.
cordance with RNABe. Apply to: Director of Nursing,
Chilliwack General Hospital, Chilliwack, British Co-
lumbia. 2-13-1
General DUlY, Operating Room and Experienced
Ob.t.trical Nur.. for 434-bed hospital with school
of nursing. Salary: $372-$444. Credit for past ex-
perience and postgraduate training. AO-hr. wk. Stat.
utory hol idays. Annual increments; cumulative sick
leave; pension plan; 28-days annual vacation; B.C.
registration required. .Apply: Director. of Nurs.ir:'9,
Royal Columbian HOlpltal, New Westminster, Brltllh
Calumbia. 2-73-13
General Duty and Operating Roam Nurse. for
modern 450-bed hospital with School of Nursing.
RNABC palicies in effect. 1966 salaries from $372
per month and up. Credit for past experience and
pOSTgraduate training. British Columbia registration
required. For particulars write to: the Director of
Nursing Service, St. Joseph'. Hospital, Victoria, British
Columbia. 2-76-5
Graduate Nur.e. for 31-bed hospital on B.e. Coast.
Salary $372 for B. C. Registered Nurses plus $15
northern living allowance. Personnel policies in
accordance with RNABe. Travel from Vancouver
refunded after 6 mos. Apply: Administrator, General
Hospital, Ocean Falls, British Columbia. 2-49.1
GRADUATE NURSES for 24-bed hospital, 35-mi. from
Vancouver, on coast, salary and personnel prac.
tices in accord with RNABC. Accommodation availa-
ble. Apply: Director of Nursing, General Hospital,
Squamish, British Columbia. 2-68-1
GRADUATE NURSES: Join us at the booming center
af B.C.II Surrounded by 50 beautiful lakes with
excellent boating, swimming, fishing plus all winter
sports. On hour's drive from Prince George, the
fastest growing city in Canada. Active 44-bed hos-
pital and modern nurses' residence over looking the
picturesque Nechako River. Starting salary $372 - $408,
recognition given for experience. Health and pension
plan, AD-hr. week and 4 weeks vacation. Write. to:
Mrs. M. Grant, Director of Nursing, St. John Hospital,
Vanderhoof, British Columbia. 2-74-1
THE CANADIAN NURSE 59
Registered Nurses for 21-bed hospitol in pleosont
community - Eastern Shore of Nova Scotia. Apply:
Superintendent, Eastern Shore Memorial Hospital,
I Sheet Horbour, Nova Scotio. 6-32.1
MANITOBA .
Director of Nurses for up-to-date 38.bed hospital. I
New nurses' residence of 1964 has separate nurses
suite available. Sick leave, pension plan and other
fringe ber.efit$ available. Personnel policies will be
sent on request. Enquiries should include experience,
qualifications and salary expected, and should be
addressed to: Mr. O. Hamm, Administrator, Altona
Hospital District No. 24, Box 660, Allono, Monit3_
i
BRITISH COLUMBIA
Graduate Nurses and Certified Nursing Alsistants
for lO-bed acute General Hospital on Pacific Coast.
Solary for Groduates in accordance with RNABC
scale with credit for experience; B.C. Registered
Procticols $260-$296. Board and room $25/m; 4-wk.
vacation affer I-yr. Superannuation and medical
plans. Apply: Director of Nursing, St. George's
Hospital, Alert Bay, British Calumbia. 2-2-1
Registered Nurses (2) for 50-bed General Hospitol in
Fort Churchill, Monitoba. Starting salary $470 per
,nonth with higher 1967 schedule effective January 1.
Train fare from Winnipeg refunded after six months
service, and return fare refunded after one year
service. Apply to: Director of Nursing. For
Churchill General Hospital, Fort Churchill, Mani-
roba. 3-75-1
Registered Nurses (:2) for 2J-bed modern hospital.
Duties to Ccmmence as soon as possible. Salary min.
$405 - $490 with fringe benefits. living-in aCCOm-
modation available. A copy of our personnel policies
will be mailed on request. Apply to: Mrs. C. James,
Motron, Gilbert PI"ins District Hospital, Gilbert
Plains, Manitoba. 3-25-2
THE GlENBORO HOSPITAL has a position avoilable
for one Registered Nurse, effective as soon as pos-
sible. Glenboro Hospital is a 16-bed hospital 10-
coted 100 miles west of Winnipeg on No. 2 High.
way. Excellent residence accommodation available.
Starting salary Jonuory 1st 1967 - $395 per month.
Personnel Policy Manual and application forms on
request with no obligation. Please forward all en-
Quiries to: Mr. S_ A. Oleson, Box 130, Glenboro,
Manitoba. Telephone No. 115 or No. 17 3-28-1
Registered Nurse' for 18-bed hospital at Vita Monitoba,
70 miles from Winnipeg. Daily bus service. Salary
ronge $380 - $440, with ollowance for experience_
40 hour wee:.:, 10 statutory holidays, 4 weeks paid
vacation after one year. Full maintenance available
for $50 per month. Apply: Matron, Vita District
Hospital, Vita, Manitoba. 3-68-1
Registered Nurses and Licensed Practical Nunes for
232-bed Children's Hospital, with school of nursing;
active teaching center. Positions available on all
services. Apply: D;rector of Nursing, Children's Hos-
pital, Winnipeg 3, Monifoba. 3-72.1
Registered Nurse for General Duty in 20-bed hospital.
Solary ronge $380 - $440 per month to be increased
Jan. I, 1967. Room and board avoiloble at $55.50
per month. Generous personnel policies. Full details
available on request. Apply: Director of Nursing,
Reston Community Hospital, Reston, Man. 3.46-2
Registered Nurses for General Duty for the newly
built Swan River Hospital. Swan River is a progres-
sive town with excellent shopping and recreational
focilities. Sclary ronge $360 - $400 with excellent per-
sonnel policies. For full details contact: Mrs. E. R.
Boudin, Director of Nursing, Swan River Hospitol,
Swan River, Manitoba. 3-62-2
General Duty Nurses for 1 DO-bed active trea!ment hos-
pital. Fully accredited. 50 miles from Winnipeg on
Trons Canoda Highway. Apply: Director of Nursing
Service, Portage District General Hospital, Portage La
Proirie, Monitobo. 3.45.1
Registered Nurses for General Duty in 18-bed hospitol.
Daily bus service to larger centres. Starting salary
$395 per month. All fringe benefits ond residence
ovailable. Apply: Director of Nursing, Crystal City
Memoriol Hospital, Crystal City, Monitoba. 3.16-1
NEW BRUNSWICK
ADMINISTRATOR for TobiQue Volley Hospital, PlaSler
Rock New Brunswick. For further information apply:
G. D: Gerrish, Secretary, Board of Management. 4-20-1
NOVA SCOTIA
SUPERINTENDENT for 16-bed hospitol, located in
60 THE CANADIAN NURSE
I I
NOVA SCOTIA
Cape Breton Highland National Park. This posi!ion
will be availoble January 1, 1967. Accommodations
available. APPLY: giving qualifications to Secretary,
Buchanan Memorial Hospital, Neil's Harbour, Nova
Scotia. 6-25-1
ONTARIO
Operoting Room Supervisor for 70-bed fully occredited
hospital. Competitive salary, good personnel policies.
For complete information apply to: Director of Nursing,
Alexandra Hospital, Ingersoll, Ontario. 7-60-1
Co
ordinator of Clinical Nursing Studies in the
Bachelor of Science in Nursing Course: The School
of Nursing, McMaster University, .i
vit!s ap:plic
ti.ons
from persons with advanced qualifications In clinical
nursing. The position is open for the 1967-1968
session with duties commencing July 1967. Pleose
apply 'sending curriculum vitae and two references
to: Director, School of Nursing, McMaster University,
Homilton, Ontorio. 7-55-15
Registered Nurses for 34-bed hospital, min. salary
$387 with regular annual increments to maximum
of $462. 3-wk. vacotion with pay; sick leave after
6-mo. se vice. All Stoff - 5 doy 40-hr. wk_, 9
statutory holidays, pension plan and oth-:r
enefits.
Apply to: Superintendent, Englehort & D,stroct Hos-
pital, Englehart, Ontario. 7.40-1
Registered Nurses. Applications and enquiries are
invited for general duty positions on the stoff of the
Monitouwadge General Hospitol. Excellenr salary
and fringe benefits. Liberal policies regardin
ac-
commodation and vacation. Modern well-eqUipped
33-bed hospita( in new mining town, about 250-mÎ.
eost of Port Arthur and north-west of White River,
Ontario Pop. 3,500. Nurses' residence c
mprises .i
di.
vidual self.contained opts. Apply, stating quallflca.
tions, experience, age, marital status, pho
e numbe
,
etc. to the Administrator, General Hospital, Mam-
touwadge, Ontario. Phone 826-3251 7.74-1 A
Registered Nurses: Applications are invited for Gener-
01 Duty Staff Nurses; Gross salary ronge: $362 to
$422. Supervisory advancement opportunities. Reside.nt
accommodations available; Hospital situated in tOUrist
town off Lake Huron. For further information write:
Superintendent, Saugeen Memorial Hospital, South-
ompton, Ontario. 7-122-1
Registered Nurses for 35.bed active treatment h
spltal,
35 m:les north east of Toronto, Ontario. Minimum
salary $355 per month, and annual increments. Per-
sonnel policies including, M.edical, O.H.S.C., weekly
Indemnity Insurance, Ontario Hospital Pensi
n Plan,
and Group life Insurance shared by th
hOSPltol, plus
other benefits. Apply to: The Superintendent, The
Cottage Hospital (Uxbridge), Uxbridge, Ontario.
7-135-1
REGISTERED NURSES for 18-bed General Hospitol in
Mining and Resort Town of 5,000 people. Beautifully
located on Wawa Lake, 140 miles north of Sault Ste.
Marie Ontario. Wide variety of Summer and Winter
sports; swimming, boating, fishing, go
fing, skat.ing,
curling and bowling. Six churches of different fOlths.
Salory range $375 - $450 per month. Starting salary
uP to $405; salary review at 3, 6, 12 mO'!ths frc:>>m
date of hire and annually thereafter. D,fferent.o!
pay for a'te:noon and night shifts. Bed and board
available at reasonable rate. Excellent personnel
policies. PI!!asant working conditions. Apply to: .The
Administrator, The Lady Dunn General Hospital,
Wawa, Ontario. 7-140-1A
Registered Nur,es and Registered Nursing Assistants,
for 100-bed General Hospital, situated in northern
Ontario. Starting salary, Registered Nu.ses $390 per
month. Registered Nursing Assistants $273 per month,
shift differential, annual increment, 40 hour week,
O. H. A. pension plan and group life insurance,
O. H. S. C. and P. 5. I. pions in effect. Accommodo-
tion available in residence if desired. For full por-
ticulars apply: The Director of Nurses, lady Minto
Hospital, Cochrc.ne, Ontario. 7-30-1 A
Regiltered Nurses and Registered Nursing Assistants
are invited to make applicat;on to oJr 75-bed,
modern General Hospital. You will be in the Vaca
tionland of the North, midway between the Lokeheod
and Winnipeg, Mal"itoba. Basic salar.ies ore $371
and $259 with yearly increments. WrIte or phone:
The Dire
tor of Nursing, Dryden District General
Hospital, DRYDEN, Ontario. 7-26-1 A
REGiSTERED NURSES AND REGISTERED NURSING
ASSISTANTS (IMMEDIATElY) for a new 40-bed hos.
I I
ONTARIO
pital with nurses' residence. Nurses
minimum salary
$387 plus experience allowance, 3 semi-annual incre
.-rents of $10 each. R.N.A:s - $270 plus experience
ollowance, 2 annua[ increments of $10 each. Reply to:
The Director of Nursing, Geraldton District Hospital,
Geroldton, Ontario. 7-50-1
Registered Nurses and Registered Nursing Assistants
far 160-bed occredited hospital. Storting salary $387
and $260 respectively with regular annual incre-
ments for botn. Excellent personnel policies. Resid-
ence accommodation available. Apply to: Director of
Nursing, Kirkland & District Hospital, Kirklond lake,
Ontario. 7-67-1
Registered Nurses and Registered Nursing Assistants:
Applications are invited from R. N's and R. N. Ass'ts.
who are interested in returning to "nursing at the
bedside" in 0 well-equipped General Hospitol. excel-
lent starting salaries and fringe benefits now. Further
increase January 1, 1967. Residence accommodation if
desired. For full particulars write to: Director of
Nursing, Sioux lookout General Hospital, P. O. Box
909, Sioux lookout, Ontorio. 7-119-1 A
Registered or Graduate Nurses, required for modern
92-bed hospitol. Residence accommodation $20 month-
ly. Overseas nurses ,^elcome. Lovely old Scottish
Town near Ottowa. Apply: Director of Nursing, The
Greot War Memorial Hospital, Perth, Ontario. 7-100-2
Registered Nurses for General Duty in well-equipped
28-bed hospital, locoted in growing gold mining
ond tourist area, north of Kenora, Ontario. Modern
residence with individual roomS; room, board and
cniform laundry only $45. 40-hr. wk., no split shift,
cLmulorive sick time, 8 statutory holidays and 28
day paid vacation after one year. Starting salary
5400. Apply to: Matron, Morgaret Cochenour Memo.
rial Hospital, Cochenour, Ontario. 7.29-1
Registered Nurses for General Duty and Operating
Room, in modern 1 DO-bed hospital, situated 4D miles
from Ottawa. Excellent personnel policies. Residence
occommodation available. Apply to: Director of
Nursing, Smiths Falls Public Hospital, Smiths falls,
Ontorio_ 7-120-2A
Registered Nurses for General Duty in 1000bed hos-
pital, located 30-mi. from Ottawa, are urgently re.
Quired. Good personnel policies, accommodation
available in new staff residence. Apply: Director of
Nursing, District Memorial Hospital, Winchester, On-
torio_ 7-144-1
Registered Nurses for General Duty and Operating
Room in modern hospital (opened in 1956)_ Situated
in the Nickel Capitol of the world, pop. 80,000
people. Salary $372 per mo., with annual merit
increments, ph..s anr'lual bonus pion, 4D-hr. wk. Recog-
nition for experience. Good personnel policies. Assist-
ance with transportation can be arranged. Apply:
Director of Nursing, Memorial Hospital, Sudbury,
Ontario. 7-127-4
General Duty Nurses for 66-bed General Hospitol.
5torting salary: $375/m. Excellent personnel policies.
Pension plan, life insurance, etc., residence accom-
modotion_ Only 10 min. !rom downtown _Buffolo.
Apply: Director of Nursing, Douglas Memonal Hos-
pital, Fort Erie, Ontario. 7-45-1
Generol Duty Nurses for loo-bed modern hospitol.
Southwestern Ontario, 32 mi. from London. Salary
commensurate with experience and obility; $398/m
basic salary. Pension plan. Apply giving full par
tlculors to: The Director of Nurses, D:strict Memorial
Hosp,tol, Tillsonburg, Ontorio. 7-131-1
General Duty Nurses, Certified Nursing Assistants &
Operating Room Technician (I) for new 50-bed hos-
pital with modern equipment, 40-hr. wk., 8 statutory
holidays, excellent personnel policies & opportunity
for advancement. Tourist town on Georgian Bay
Good bus connections to Toronto. Apply to: Director
of Nurses, General Hospitol, Meoford, Ontario. 7-79-1
General Staff Nurses and Registered Nursing Assit..
tants are required for a modern, well-equipped General
Hospitol currently exponding to 167 beds. Situoted in
a progressive community in South Western Ontario, 30
miles from Windsor-Detroit Border. Salary scaled to
experience and Qualifications. Excellent employ.ee
benefits and working conditions plus an opportumty
to work in a Patient Centered Nursing Service. Write
for further information to: Miss Patncia McGee, B.
Sc.N., Reg.N. Director of Nursing, Lear:nington District
Memorial Hospital, Leamington, Ontaflo. 7-69-1 A
PUBLIC HEALTH NURSE (QUALIFIED) For generalized
Public Health programme. Present salary under revi-
sion. Direct enquiries to: Miss Beatrice Whalley, Super-
visor of Public Health Nursing, Waterloo Country
Heolth Unit, 109 Argle Street, South. PRESTON, ON-
TARIO 10.109-2
JANUARY 1967
EL CAMINO HOSPITAL
Registered Nurses -
All Services
Sfarting salary for
Experienced
Regisfered Nurses
$550 per month
448-bed fully-occred-
ited general hospi-
tal located 40 min-
ufes south of
downfown Son
Francisco
Ample opportunify
for professional
development as
there are two col-
leges and two uni-
versities in the
immediate vicinity
Excellent recreafional
facilifies in close
proximify to The
hospifal
.
LOCATED IN BEAUTIFUL SANTA CLARA VALLEY
YEAR 'ROUND SMOG-FREE TEMPERATE CLIMATE
-
-
.,
...
'f'"
Benefits Include:
Plonned orientation
program
Continuing in-service
educafion
Two fo four weeks
vacation
Eighf paid holidays
Accumulative sick
leave
Free group life
insurance
.
Fully paid health in-
surance including
family coverage
Fully paid refirement
program
liberal shift
differential
40-hour week
..
; w _
, "....
-..
..... .1. -"
DIRECTOR
OF NURSES
Applications are invited for this
position in a 44-bed active Gen-
eral Hospital. Position carries a
good deal of responsibility in-
cluding nursing personnel, phar-
macy, new projects planning.
New projects are two new hos-
pitals with centralized services
and exciting concepts for mod-
ern patient care. Located in Cen-
tral British Columbia, one hour
west of Prince George in an area
of noted development, this dis-
trict abounds with lakes and
forests, good summer and winter
sports. Excellent salary and staff
benefits depending on qualifi-
cations and experience.
Apply to:
Administrator
ST. JOHN HOSPITAL
Vanderhoof,
British Columbia
JANUARY 1967
''to
, .
.......
t " '
...\
Apply to:
PERSON N EL DI RECTOR
EI Camino Hospital
2500 Grant Road
Mountain View r California 94040
ASSISTANT DIRECTOR
OF NURSING
Applicafions are invifed for the position
of Assisfont Director of Nursing in on
occredited, modern, 244-bed ocufe-care
hospital. locafed in the rapidly growing,
scenic interior of Brifish Columbia, this
hospital is undergoing progressive ex-
pansion.
Nursing adminisfrative education and ex-
perience desirable. Salary commensurafe
with qualifications.
Suite availoble in stoff residence.
Apply stating qualifications and
expected salary to:
Director of Nursing
PRINCE GEORGE REGIONAL
HOSPITAL
Prince George, British Columbia
OPERATING ROOM
SUPERVISOR
With Postgraduate Course in
Operating Room technique
and management
Required for a 375-bed fully
accredited General Hospital with
projected reconstruction program.
Salary based on qualifications
and experience.
Fringe benefits include hospital
and medical coverage, generous
sick leave, three weeks' vacation
and contributory pension plan.
For further information write:
Director of Nursing Service
METROPOLITAN
GENERAL HOSPITAL
Windsor, Ontario
THE CANADIAN NURSE 61
r
ONTARIO
OPERATING ROOM NURSES (2) for 0 fully oc.
credited 70-bed Generol Hospital. For Operating
Room Duty. Salary according to experience. Apply to:
O.R. Supervisor. Penefanguishene General Hospital,
Penetanguishene, Ontario. 7-99-2
Public Health Nurses for generalized program. Every
modern fringe beneiit. Full credit for experience.
Present solary ronge $5,030 - $6,148. Further, we
are prepared to give consideration to any salary
request. Apply to, E. G. Brown, M.D., D.P.H. Director
ond M.O.H., Kent County Health Unit, 21 - 7th. St.,
Chothom, Ontorio. 7-24-4
PUBLIC HEALTH NURSES (2 QUALIFIED) - Staff
positions available in the City of Oshawa. Duties to
commence January 3rd. 1967. General ized program
in an official agency. Solary $5,658 to $6,507.
Beginning salary according to experience. Liberal
personnel policies and fringe benefits. Apply to: Mr.
D. Murray, Personnel Officer, City Hall, 50 Centre
Street, Oshawa, Ontario. 7-92-2
Public Health Nunes for generalized programme in
o County-City Health Unit. Salary schedule as of
January I, 1967, $5,100 to $6,100. 20 days vacation.
Employer shared pension pion, P.S.1. and hospital-
ization. Mileage allowance or unit cars. Apply to:
Miss Veronica O'Leary, Supervisor of Public Health
Nursing, Peterborough County-City Health Unit, P.O.
Box 246, Peterborough, Ontario. 7-101-4A
PUBLIC HEALTH NURSES for generalized public health
program. Good personnel policies including 4 weeks'
vacotion, sick time allowance, unit car or car allow-
ance, shared pension plan, hospitalization, and
group insurance available. Apply to: Mrs. Muriel
McAvoy, Secretary-Treasurer, Porcupine Health Unit,
70 Balsam Street South, Timmins, Ontario. 7-132-2
QUEBEC
RESIDENT CHilDREN CAMPS IN THE lAURENTIANS,
REQUIRE: Graduate Nur.e. for the summer. Apply:
JEWISH COMMUNITY CAMPS, 6655 Cote des Neiges
Rood, Suite 260, Montreal 26, Quebec. Phone
735-3669. 9-47-63A
SASKATCHEWAN
DIRECTOR OF NURSING for modern 24-bed active
treatment hospital. Graduates in nursing administration
or with experience will be given preference. Accommo-
dation available in nurses' residence. Salary schedule
will be based on the SRNA recommondations. Apply:
Mr. R. Holinaty, Administrator, Wakaw Union Hospital,
Wokaw, Soskatchewon. 10-131-1 A
MATRON for 10.bed hospital at Willow Bunch in
South Centro I Soskatchewan. Population 600; bus
service, modern utilities, recreational facilities, friend-
ly folks. $450 per month; 40 hour week. Room in
nurses' residence and board in hospital supplied at
low cost. Call or write: R. Granger, Sec.- Treas.,
Willow Bunch Union Hospital, WilLOW BUNCH,
Soskatchewan. - PHONE: 473-2450 (Area Code 306).
10.138-1
Regist.red Nu.... wanted for 12-bed hospital. Solaries
and benefits as per SRNA schedule. Residence accom-
modation on hospital grounds. Daily bus service to
cities. Apply fa: The Matron, Mr.. M. Gile., Caronach
Union Hospital, Coronach, Saskatchewan. 10-18-1
REGISTERED NURSE for 9-bed haspital. Duties to
commence as soon as possible. Salary accarding to
SRNA schedule with allowance for experience. Room
and board for $34.50 per month. Apply to: Secre-
tary, Hodgeville Union Hospital, Hodgeville, Sos-
kotchewan. 10.45.1
REGISTERED NURSES far 24-bed active treotmenT hos-
pital. Established personnel policies and pension plan.
Solary range as per SRNA recommendatians. Adjust-
ments to starting salary made for previous experience.
Residence accommodation available at $43.50 per
month. Apply: Mrs. Z. Johnson, Acting Director of
Nursing, Wakaw Union Hospital, Wakaw, Saskatche-
wan. 10-131-1
Registered Nurse and Certified Nursing Alliltont for
45-bed General Hospital in progressive north central
Soskatchewan community. Daily bus service to two
maior cities. SRNA policies and salaries in effect
plus added fringe benefits, ie. group life insurance.
pension plan, accumulative sick leave to 120 days.
Board and lingle rooms available in residence at
$43.50 per month. Apply ta: Mrs. C. Fisher, R.N.,
Acting Director af Nursing, Wadena Union Hospital,
Wadena, Sask. 10-130-1
62 THE CANADIAN NURSE
I I
SASKATCHEWAN
Regi.t.r.d Nur... far G.neral Duty (2) in fully
modern 27-bed ho.pital. Initial salory $364 per month.
Personnel policies according to Sask. Reg. Nurses' As-
sociation recammendations. New modern residence,
excellent working conditions. Duties to commence
when convenient. Apply to: Superintendent of Nursing
Services. Kipling Memorial Union Hospital, Kipling,
Soskatchewon. 10-59-1
General Duty and Operating Room Nurses, also
Certified Nursing Assistants for 560-bed University
Hospital. Salary commensurate w.th experience and
preparations. Excellent personnel pol icies. Excellent
opportunities to engage in progressive nursing. Ap-
ply: Director of Personnel, University Hospital, Sas-
kotoon, Saskotchewan. 1O.1t6-4A
UNITED STATES
Regist.r.d Nurs.. wanred for 78-bed General Hos-
pital. Staning salaries at $525 per month with
regular increments and shift differential. Good per.
sonnel policies. Social activities include skiing and
boating. Must be eligible for Alaska registration.
Apply to: The Director of Nursing Service, St. Ann's
Hospital, 419 - 6th Street, Juneau, Alaska 99801.
15-2-3
REGISTERED NURSES - Southern Californio - Op.
portunities available - 368-bed modern hospital in
Medical-Surgical, Labor and Delivery, Nursey, Oper-
ating Room and Intensive and Coronary Care Units.
Good salary and liberal fringe benefits. Continuing
inservice education program. Located 10 miles from
Los Angeles near skiing, swimming, cultural and edu-
catianal facilities. Temporary living accommodations.
Apply: Director of Nursing Service, Saint Joseph
Hospital, Burbank, California 91503. 15.5-63
REGISTERED NURSES needed for rapidly expanding
general hospital on the beautiful Peninsula near
San Francisco. Outstanding policies and benefits,
including temporary accommodatians at law cost,
health coverage, fully refundable retirement plan,
liberal shift differentials, no rotation, exceptional
in-service and orientation programs, unl imited sick
leave accrual, unlimited vacation accrual, sick leave
conversion to vacation, tuition reimbursement. Ex
cellent salaries based on experience. Cantact Person-
nel Administrator, Peninsula Hospital, 1783 EI
Camina Real, Burlingame, California - 697-4061.
15-5-20 B
Registered Nurses, Career satisfaction, interest and
professional growth unlimited in modern, JCAH ac-
credited 243-bed hospital. Locoted in one of Califor-
nia's finest areas, recreational, educational and cul-
tural advantages are yours as well as wonderful
year-round climate. If this combination is what
you're looking for, contact us nowlStaff nurse en-
trance salary abave $500 per month; increases to
$663 per month; supervisory positions at highest
rotes. Special area and shift differentials to $50 per
month poid. Excellent benefits include free heolth
and life Insurance retirement, credit union and liberal
personnel policies. Profenional staff appointments
available in all clinical areas to those eligible for
California licensure. Write today: Director of Nursing.
Eden Hospital. 20103 lake Chabot Road, Costro Val-
ley, Californio. 15-5-12
REGISTERED NURSES Opportunities available at
415-bed hospital in Medical-Surgical, labor and
Delivery, Intensive Care, Operating Room and Psy-
chiatry. No rotation of shift, good salary, evening
and night differentials, liberal fringe benefits.
Temporary living accommodations available. Apply:
Miss Dolores Merrell, R.N., Personnel Director, Queen
of Angels Hospital, 2301 Bellevue Aevnue, los
Angeles 26, Cal ifornia. 15-5-3G
REGtSTERED NURSES - Come to smog-free Orange
in California. Near beaches and mountains; 35 miles
from los Angeles. New, modern 290-bed St. Joseph
Hospital and adjoining 50-bed Childrens Hospitol of
Orange County. Need staff nurses all .hifts in
surgical, medical, pediatrics, intensive care unit,
cardiac care unit, neuropsychiatric unit, operating
room, emergency room, and recovery room. Excellent
salary and benefits. Write to: Persannel Director,
St. Joseph Hospital, Orange, California, for personnel
policy handbook and details regarding salaries, etc.
15.5-56
REGISTERED NURSES - SAN FRANCISCO Children's
Hospital ond Adult Medical Center hospifal for men.
women and children. California registration required.
Opportunities in all clinical areaS. Excellent salaries.
differentials for evenings and nights. Holidays, vaca-
tions, sick leave, life insurance, health insurance and
employer
paid pension-plan. Applications and details
furnished on reQuest. Contact Personnel Director, Chil.
dren's Hospital, 3700 California Street, San Francisco
18, Californio. 15.5-4
REGISTERED NURSES - Generol Duty for 84-bed
JCAH hospital 1 J12 hours from Son Francisco, 2
hours from lake Tohoe. Starting salary $510/m.
I I
UNITED STATES
with differentials. Apply: Director of Nur.es, Mem-
orial Hospital, Woodland, California. 15-5-49B
R.gi.tered Nur.e. for 303-bed modern hospital. Po-
sitions available - All services, na shift rotatian.
liberal benefits, advancement apportunities, educa.
tional opportunities in area, equal opportunity
employer. Apply: Director of Nursing Service, Kaiser
Foundation Hospitals, San Francisco 15, California.
Phone (JO 7-4400) 15-5.57
REGISTERED NURSES: Mount Zion Hospital and Me.
dical Center's increased salary scales now double our
attraction for nurses wha find they can afford to live
by the Golden Gate. Expansion has created vacancies
for staff and specialty assignments. Address enquiry
to: Personnel Department, 1600 Divisadera Street, San
Francisco, California 94115, An equal opportunity em-
ployer. 15-5-4 C
Registered Nurses - California. Expanding, accredit-
ed 303-bed hospital in medical center af Southern
California. University city. Mountain - ocean resort
area. Ideal year-round climate, smog free. Starting
salary $6,300. With experience, $6,600. Fringe bene-
fits, shift differential, initial housing allowance.
Wide variety rentals available. For details on Cali-
fornia license and Visa, write: Director of Nursing,
COllage Hospitol, 320 W. Pueblo Street, Santo Bar-
bara, Californio 93105. 15.5-39 A
REGISTERED NURSES GENERAL DUTY - SURGERY.
Will assist with immigration. Come to California and
live in beautiful Sacramento which is within a
short drive of the Sierra summer and winter recrea.
tional areas. Two large modern hospitals offer an
excellent variety af nursing experiences. P.M. Staff
$555, P.M. Surgery $595. Write: Personnel Depart-
ment, Sutter Hospitals, 2820 "L" Street, Sacramento,
California. 15-5.43B
NURSE TEAM LEADER POSITIONS in new 372-bed,
fully accredited, General Hospital in resort areo. $461
per month days and $485 per month evening and
nighT shift. liberal fringe benefits. For descriptive bro-
chure and policies write: l. Sims, North Miami Gene.
ral Hospital, 1701 NE 127th Street, North Miami,
Florido. 15-10-2 A
REGISTERED NURSES: ExcellenT opportunity for ad-
vancement in atmosphere of medical excellence. Pro-
gressive patient care including Intensive Care and
Cardiac Care Units. Finely equipped growing 200.
bed suburban community hospital iust on Chicago's
beautiful North Shore. Completely air conditioned
furnished apartments, paid vacation, after six months,
staff development progrom, and liberal fringe bene-
fits. Starting salary from $466. Differential of $30
for nights or evenings. Contact: Donold L Thamp-
son, R. N., Director of Nursing, Highland Park Hos-
pital, Highland Park, Illinois 60035. 15.14-3 A
Registered Nurses and Certified Nursing Assistants.
Opening in several areas, all shifts. Every other week-
end aff, in small community hospital 2 miles from
Boston. Rooms available. Hospital paid life insurance
and other I iberol fringe benefits. RN salary $ lOOper
week, plus differentiol of $20 for 3-11 p.m. and
11-7 a.m. shifts. C.N. Ass'ts. $76 weekly plus $10 for
3-11 p.m. and 11-7 o.m. shifts. Write: Mi.s Byrne,
Director of Nurses, Chelsea Memmorial Hospital,
Chelsea, Massachusetts 02150. 15.22-1 C
NURSES, Register.d, for modern 36O-bed hospital.
Openings available in all areas, medicine-surgery,
delivery room, nursery, and postpartum. Near Wayne
State University, and on integral part of the new
Medical Center. Salary $550 ta $635 per manth
plus differential for afternoon and night. Premium
pay for weekends. Good fringe benefit. including
Blue Cross ond Life Insurance. Apply: Personnel
Director, Hutzel Hospital formerly Womon's Hospital),
432 East Hancock, Detroit, Michigan 48201. 15-23-1 F
STAFF NURSES: Needed to staff present fully occredit-
ed hospitol and new facility to open December 1967.
All services ond shifts available. Good salaries and
fringe benefits. Will pay transportation to and from.
Minimum one year contract. For particulars concerning
hospital ond community write: L E. Thompson, Ad-
ministrator, or V. Jenkins, Director of Nursing, Scioto
Memoriol Hospifal, Portsmouth, Ohia. 15-36-4
ALBERTA
General Duty Nurses and Cer1ified Nursing Aide. for
modern combined active treatment and Auxiliary
Hospital. Solary start. ot $355 ond $240 respectively.
Liberal personnel policie!., accommodation available.
located in Southern Alberto close to U. S. boundory
and Waterton-Glacier International Peace Park. The
61-bed combined hospital serves the town and area of
approximately 6,000 population with aU services,.
Apply to: The Director of Nursing, Cardston Municipol
Hospital, Box 310, Cardston, Alberta. 1-17-1
JANUARY 1967
THE HOSPITAL
FOR
SICK CHILDREN
"
1\0-
,
,
,J
1
I
I'
YOU
Receive the advantages of:
1. Five-week orientation
gram for new staff.
pro-
2. Ongoing in-service education
for nurses.
3. Extensive student education
program.
4. Research Institute.
APPLICATION FOR GENERAL
DUTY POSITIONS INVITED
For information contact:
THE DIRECTOR OF NURSING
555 University Avenue
Toronto, Canada
IANUARY 1967
UNITED STATES
I I
UNITED STATES
REGISTERED NURSES FOR STAFF AND CHARGE. Posi-
tjons in an expanding, full V accredited General
Hospital. Intensive Care, Medical, Surgical, Obste-
trical areas, and In-service Education program. Lo-
cation: Central to beaches, mountains, Stote Uni-
versity. Good salary, regular increments. Opportunity
for advancement. Apply: Director, Nursing Service,
Beverly Hospitol, 309 W. Beverly Blvd_, Montebello,
California. 15-5-59A
REGISTERED NURSES - Positions ovailoble for Charge
Nurses in beautifully equipped new convalescent hos-
pital, specializing in post surgical core. Work every
other weekend. COr]tact the Personnel Director, Berkley
Convalescent Hospital, 1623 Arizona Avenue, Santa
Monico, California 90404. t5-5-40 B
REGISTERED NURSES: for 75-bed air conditioned
hospital, growing community. Storting salory $330-
$365/m, fringe benefits, vacation, sick leave, holi-
days, life insurance, hospitalization. 1 meal furnish-
ed. Write: Administrator, Hendry General Hospital,
Clewiston, Florida. 15-10-1
Staff Duty positions (Nurses) in private 403-bed
hospital. liberal personnel policies and salary. Sub-
stantial differential for evening and night duty.
Write: Personnel Director, Hospital of The Good
Samaritan, 1212 Shatto Street, los Angeles 17.
California. 15-5-311
General Duty Nurses - Present hospital 55-beds
with new 75-bed hospital to ooen April, I, 1965.
located on lake Okeechobee near west Palm Beach.
liberal personnel policies, 40-hr. wk., bonus at end
of first year. Minimum starting salary $380, with
differential for evenings and nights. Apply: Director
of Nursing Service, Glades General Hospital, P.O.
Box 928. Belle Glade, Florida. 15.10-3
Nurses for new 75.bed General Hospital. Resort
area. Ideal climate. On beautiful Pacific ocean.
Apply to: Director of Nurses, South Coast Com-
munity Hospital, South laguna, California. 15-5-50
.
REGISTERED
. .
NURSES
.
.
.
THE
350-BED
SARNIA GENERAL
H
s
A
L
p
T
C)
ASKS
-
What Are You Seeking?
WE OFFER
the opportunity
1. to work directly with patients
2. to participate in group decisions
3. l.O.A. with financial assistance to further your
in nursing
education
If you are interested . contact the Personnel Director, Sarnia General
Hospital r Sarnia, Ontario
THE CANADIAN NURSE 63
OSHA W A
GENERAL HOSPITAL
GENERAL DUTY NURSES FOR
ALL DEPARTMENTS
Starting salary for Ontario Regis-
tered nurses $400 with 5 annual
increments to $480 per month.
Credit for acceptable previous
service - one increase for two
years, two increases for four or
more years.
Non-registered - $360.00
Rotating periods of duty - 3
weeks vacation - 8 statutory
holidays.
One day's sick credit per month
beginning in the 7th month of
service cumulative to 45 days.
Pension Plan and Group Life
Insurance - Hospital pays 50%
of Medical, Blue Cross and Hos-
pital Insurance premiums.
Apply to:
Director of Nursing
OSHAWA GENERAL HOSPITAL
Oshawa, Ontario
ST. JOSEPH'S
HOSPIT AL
HAMIL TON.
ONTARIO
A modern, progressive hospital,
located in the centre of Ontario's
Golden Horseshoe-
invites applications for
GENERAL STAFF
NURSES
and
REGISTERED
NURSING ASSISTANTS
Immediate openings are avail-
able in Operating Room, Psy-
chiatry, Intensive Care - Coro-
nary Monitor Unit, Obstetrics,
Medical, Surgical and Paediatrics.
For further information write to:
THE DIRECTOR OF NURSING
ST. JOSEPH'S HOSPITAL
Hamilton, Ontario
(,4 THE CANADIAN NURSE
REGISTERED NURSES
for General Duty
North Shore of Lake Athabaska
Modern 30-bed General Hospital,
located in young active mining
community.
Salary: $414 - $529.
Attractive nurses' residence a-
vailable. Room and board at $45
monthly. Superior employee ben-
efits. - Air transportation paid
from Edmonton or Prince Albert.
Please send enquiries to the .
Director of Nursing
MUNICIPAL HOSPITAL
Uranium City,
Saskatchewan.
DIRECTOR
OF NURSING
Applications are invited for the
position of Director of Nursing.
This is a unique hospital offering
rehabilitation and chronic care to
48 handicapped children who
present many challenges. Ex-
pansion plans are being studied
to provide rehabilitation for 18
to 21 year old adolescents. Pre-
ference will be given to a director
with preparation and experience
in nursing administration and
particular interest in rehabilita-
tion.
Please address 01/ enquiries to:
The Administrator
BLOORVIEW CHILDRENS HOSPITAL
278 Bloor Street East
Toronto 5, Ontario
ASSISTANT DIRECTOR
OF NURSING
Applications are invited for the
above position in a fully ac-
credited 163-bed General Hos-
pital in beautiful Northern On-
tario.
Desirable qualifications should
include B.S.N. Degree with ex-
perience in supervision.
For further information,
Write to:
Director of Nursing
KIRKLAND and DISTRICT HOSPITAL
Kirkland Lake, Ontario.
ONTARIO SOCIETY
FOR
CRIPPLED CHILDREN
requires
· Camp Directors
· General Staff Nurses
· Registered Nursing Assistants
for
FIVE SUMMER CAMPS
located near
OTTAWA COLLINGWOOD
LONDON - PORT COLBORNE
KIRKLAND LAKE
Applicafions are invifed from nurses in-
teresfed in fhe rehabilitafion of physically
handicapped children. Preference given to
CAMP DIRECTOR applicanfs having super-
visory experience and to NURSING ap-
plicants with paediafric experience.
Apply in writing to:
Miss HELEN WALLACE, Reg. N.,
Supervisor of Camps,
350 Rumsey Road,
Toronto 17, Ontario
JANUARY 196;
CANADA'S INDIANS
NEED YOUR
AND ESKIMOS
HELP
PUBLIC HEALTH NURSES
REGISTERED HOSPITAL NURSES
CERTIFIED NURSING ASSISTANTS
HAVE YOU CONSIDERED
A CAREER
WITH
MEDICAL SERVICES
DEPARTMENT OF NATIONAL HEALTH AND WELFARE
lor 'urther inlormation. write to:
MEDICAL SERVICES DIRECTORATE
DEPARTMENT OF NATIONAL HEALTH AND WELFARE
OTTAWA. CANADA
DIRECTOR OF NURSING
-
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Applications are invited
for the
tIP'
-
..
POSITION OF DIRECTOR OF NURSING
..
The Director of Nursing will be responsible for
the administration of all nursing services within
the hospital. The hospital currently operates
375 beds and is undergoing extensive moderni-
zation and expansion costing $3,750,000. There
is a furnished apartment available at a mini-
mum rental. A 140 student School of Nursing
housed in a modern residence and operated
by the hospital is the responsibility of a Director
of Nursing Education.
Address enquiries to:
THE SCARBOROUGH
GENERAL HOSPITAL
Invites applications from General Duty Nurses.
Excellent personnel policies. An active and stimulat-
ing In-Service Education and Orientation Programme.
A modern Management Training Programme to as-
sist the career-minded nurse to assume managerial
positions. Salary is commensurate with experience
and ability. We encourage you to take advantage
of the opportunities offered in this new and expand-
ing hospital.
Fort William. Ontario
McKELLAR GENERAL HOSPITAL
For further information write to:
Director of Nursing
SCARBOROUGH GENERAL HOSPITAL
Scarborough, Ontario
DOUGLAS M. McNABB. Administrator
JANUARY 1967
THE CANADIAN NURSE 65
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YORK COUNTY HOSPITAL
NEWMARKET, ONTARIO
HOSPITAL:
A newly expanded 257 bed hospital wifh such progressive
pofient core concepts os 0 12-bed J.e.u., 22-bed psychiofric
ond 24-bed self core un if.
IDEAL LOCATION:
45 minutes from downtown Toronfo, 15-30 minutes from
excellent summer and winfer resort areas.
SALARIES:
Registered Nurses: $372-$447 per month.
Registered Nursing Assistonfs: $277-$310 per monfh.
BENEFITS INCLUDE:
Furnished oporfmenfs, medico I ond hospifOI insuronce, group
life insuronce, pension plan, 40 hour week.
Please address 01/ enquiries to:
Director of Nursing
YORK COUNTY HOSPITAL
596 Davis Drive
Newmarket, Ontario
TEACHERS OF NURSING
By August, 1967 the Royal Victoria Regional School
of Nursing requires three teachers in medical-surgical
nursing, two in Operating Room techniques and one
in psychiatric nursing.
Teachers qualified with a baccalaureate degree or a
diploma in nursing education will assist in classroom
teaching and accompany the students to one of the
six regional hospitals for clinical experience.
This is a new programme in an independent school.
The faculty are eager to develop the best possible
curriculum. A new building for classrooms will be
erected in 1967.
Barrie is fifty miles north of Toronto and noted for its
summer and winter spon facilities.
Solaries are at the Toronto level with increments paid
to experienced teachers. Personnel policies and job
descriptions will be sent on request.
Please write to:
The Director,
ROYAL VICTORIA REGIONAL SCHOOL OF NURSING
61 Wellington Street West, Barrie, Ontario.
66 THE CANADIAN NURSE
MAIMONIDES HOSPITAL
AND HOME FOR THE AGED
AN OPPORTUNITy....
A CHALLENGE....
A NEW EXPERIENCE....
SUPERVISORS, STAFF NURSES, NURSING
ASSISTANTS, INSTRUCTORS, PSYCHIATRIC
NURSE:
We invite you to join the nursing staH of New Mai.
monides.
LIBERAL VACATION " HEALTH AND
PENSION PLANS . . SALARIES COM.
MENSURA TE WITH RECOGNIZED SCALES
Apply to:
DIRECTOR OF NURSING
5795 Caldwell Avenue
Montreal 29, Quebec
THE ST. CA THARINES
GENERAL HOSPITAL
A modern SOO-bed hospital located in the heart
of the beautiful Niagara Peninsula, within
easy travel distance from Buffalo, Hamilton
and Toronto, invites applications from: Gener-
al Staff Nurses.
Pleasant working conditions. Excellent per-
sonnel policies.
Apply:
The Director of Nursing Service
THE ST. CATHARINES
GENERAL HOSPITAL
St. Catharines, Ontario
JANUARY 1967
What does
Methodist Hospital
have to offer me?
At the Methodist Hospital, where research is a part
of progress, a nursing career takes on new horizons -
rich in meaning and professional satisfaction.
If you're looking for the chance to be the nurse
you've always dreamed of - coming to the world
famous Methodist Hospital can be an adventure -
almost like stepping into the future - splendid
facilities, so much advance equipment and
everywhere the newest medical and patient care
techniques are in use.
Some of the best aspects of nursing at METHODIST
are as old as medicine itself - there is a spirit of
kindness and consideration, and emphasis on patient
care, that make this a hospital where nursing is
satisfying and rewarding, day by day.
Methodist Hospital is right in the center of the world's
great Medical, Research and Educational complexes.
HOUSTON is an exciting city - rodeo and opera,
pro-football and the famous Alley Theatre, water sports
and beaches an hour or less away, the Houston
Symphony and the Astrodome!
A Few Quick Facts: We're affiliated with Baylor
University College of Medicine and associated with
Texas Woman's University College of Nursing.
New $9>'2 million Cardiovascular and Orthopedic
Research Center will open soon. Our Inservice
EducatIon Department gives you thorough
orientation, and continued instruction in new
concepts and techniques. You'lIlind every
encouragement to broaden your Skills,
including tuition assistance in obtaining
further education in nursing.
..
Send for Your Colorful Informative Illustrated
Brochure. . . to learn about Methodist Hospital,
Houston, positions available, salary and employment
benefits, tuition allowance, complimentary room
accommodation and our Nurse Specialist Programs.
Write, call or send coupon, Director of Personnel,
The Methodist Hospital, Texas Medical Center,
Houston, Texas 77025
....j
r-------------------------------------ì
I Director of Personnel, THE METHODIST HOSPITAL, Texas Medical Center, Houston, Texas 77025 I
I Please send me your brochure about nursing opportunities at "(HE METHODIST HOSPITAL-Texas Medical Center I
I I
I Name I \.
I Address I
I I
I City State Zip Code I
L_____________________________________
DIRECTOR OF SCHOOL
OF NURSING
REQUIRED FOR
DISTRICT SCHOOL OF NURSING
The
Canadian
Nurse
1965 INDEX
Minimum Requirement - B. Sc. N., with five years
experience, two of these in Nursing Education.
Apply to:
Mr. Harold Swanson, Chairman,
BOARD OF NURSING EDUCATION
220 Clarke Street
WOODSTOCK, ONTARIO
An index of materials appearing
in Volume 61 of
THE CANADIAN NURSE
is now available.
Write for your copy to
Miss PIERRETTE HOTTE
at National Office,
50 The Driveway,
Ottawa 4
THE CANADIAN NURSE 67
JANUARY 1967
ADDITIONAL CLINICAL TEACHERS
required
to assist in Developing New Curriculum and a
Regional School.
School of Nursing Building is New
and well equiped.
Salaries and Fringe Benefits at Metropolitan level.
Qualifications - B.Sc.N.
or
Diploma in Nursing Education.
GENERAL STAFF NURSES
Required for all Services
Salaries and Fringe Benefits at Metropolitan level.
Apply to:
DIRECTOR OF NURSING
BRANTFORD GENERAL HOSPITAL
Brantford, Ontario
MANITOBA ASSOCIATION
OF REGISTERED NURSES
Invites applications lor the positions 01
REGISTRAR
Applicants are required to hold a baccalaureate degree in nursing
wifh experience in odministrafion, and in inferpersonal relafions.
Duties include providing for registrafion and membership in the
M.A.R.N. and fhe mainfenance of the official register of member
of the Association.
Salary to be Negofiafed.
and
PERSONNEL OFFICER
The applicant musf have the following qualifications:
Baccalaureafe Degree desirable. Masfer's Degree preferred.
Experience in administration and in working with individuals and
organizations desired.
Duties include promotion of the economic and social welfare of
nurses.
Salary to be Negotiated.
All Inquiries shoutd be Addressed to:
Mrs. Helen P. Glass, President,
MANITOBA ASSOCIATION Of REGISTERED NURSES,
247 Balmoral Street,
Winnipeg 1, Manitoba,
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STAFF NURSE POSITIONS
Salary Range $482-$620
with maximum starfing $539 on day shift.
$592 evening and/or night shifts. Credit
given for education and/or experience.
Opportunity to gain knowledge and skill
in a specialized cancer research hospital.
Registration in Texos required. Excellenf
personnel benefits include: 3 weeks vaca-
tion, holidoys, cumulative sick leave,
laundry of uniforms furnished, refirement
ond Social Securify programs, Hospitaliza-
tion, life and Disabilify Income Insurance
available. Equal opportunity employer.
UNIVERSITY
OF ALBERTA
HOSPIT AL
Positions are available in our
rapidly expanding Medical Cen-
tre situated on a growing Uni-
versity campus. All service in-
cluding renal dialysis, coronary
intensive care and cardiac surg-
ery offer opportunities for ad-
vancement.
For applicafion and additional information
Write to:
Personnel Manager
THE UNIVERSITY Of TEXAS
M.D. ANDERSON HOSPITAL AND
TUMOR INSTITUTE
Apply to:
Director of Nursing
UNIVERSITY Of ALBERTA
HOSPITAL
Edmonton, Alberta
Texas Medical Center
Houston, Texas 77025
68 THE CANADIAN NURSE
RIVERSIDE
HOSPIT AL
OF OTTAWA
A new, air-conditioned 340-bed
hospital. Applications are called
for Nurses for the positions of:
HEAD NURSE - Operating Room
ASSISTANT HEAD NURSES
GENERAL STAFF NURSES
and
REGISTERED NURSING ASSISTANTS
Address all enquiries to:
Director of Nursing
RIVERSIDE HOSPITAL OF OTTAWA
1967 Riverside Drive,
Ottawa, Ontario
JANUARY 1967
PALO ALTO-STANFORD
HOSPITAL CENTER
located on the beautiful campus of Stanford University in Palo Alto, California.
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"We invite you to join our professional staff and to gam unparalled experiences in
nursing."
For additional information-
NAME:
ADDRESS:
CITY:
SERVICE DESIRED:
Return to: PALO ALTO-STANFORD HOSPITAL CENTER
Personnel Department
300 Pasteur Drive
Palo Alto, California
STATE:
REGISTE RED NURSES
REGISTERED NURSING
ASSIST ANTS
REQUIRED FOR
ST. MARY'S HOSPITAL
TIMMINS, ONTARIO
MODERN - 200 BED HOSPITAL
EXCELLENT PERSONNEl POLICIES
PLEASANT TOWN OF 30,000
WIDE VARIETY OF SUMMER
AND WINTER SPORTS -
SWIMMING, BOATING,
FISHING, GOLFING, SKATING,
CURLING, TOBOGGANING,
SKIING AND ICE FISHING.
Apply to:
Director of Nursing Service
ST. MARY'S HOSPITAL
Timmins, Ontario
IANUARY 1967
VICTORIA HOSPIT At
LONDON, ONTARIO
Modern 1,000-bed hospital
Requires
Registered Nurses for
all services
and
Registered
Nursing Assistants
40 hour week - Pension plan
- Good salaries and Personnel
Policies.
Apply:
Director of Nursing
VICTORIA HOSPIT At
London, Onto
ST. JOSEPH'S HOSPITAL
TORONTO, ONTARIO
REGISTERED NURSES
and
REGISTERED
NURSING ASSISTANTS
700-bed fully accredifed hospital provides
experience in Operating Room, Recovery
Room, Intensive Care Unit, Pediatrics
Orthopedics, Obstetrics, General Surgery
and Medicine.
Orientation and Acfive Inservice program
for all staff.
Salary is commensurafe wifh preparafion
and experience.
Benefits include Canada Pension Plan,
Hospital Pension Plan, Group Life I nsu-
ranee. Sick leave - 12 days after one
year, Ontario Hospifal Insuranæ - 50%
payment by hospital.
Rofafing Periods of duty - 40 hour week,
8 sfatutory holidays - annual vacation
3 weeks offer one year.
Apply:
Assistant Director of
Nursing Service
ST. JOSEPH'S HOSPITAL
30 The Queensway
Toronto 3, Ontario
THE CANADIAN NURSE 69
THE HOSPITAL
FOR
SICK CHILDREN
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OFFERS:
1. Satisfying experience
2. Stimulating and friendly en-
vironment.
3. Orientation and In-Service
Education Program.
4. Sound Personnel Policies
5. liberal vacation.
APPLICA TrONS FOR REGISTERED
NURSING ASSISTANTS INVITED.
For detailed information
please write to:
The Assistant Director
of Nursing
AUXILIARY STAFF
555 University Avenue
Toronto, Ontario, Canada
70 THE CANADIAN NURSE
HUMBER MEMORIAL HOSPITAL
HOSPIT AL -
Newly expanded 350-bed hospital. Progressive patient care con-
cept.
SALARY -
General Staff Nurses (Currently Registered in Ontario) $400.00 -
$480. - 5-increments.
Registered Nursing Assistants (Currently Registered in Ontario)
$295.00 - $331.00, - 3 increments.
HOUSING -
Furnished apartments available at subsidized rates.
JOB SATISFACTION -
High quality patient care and friendly working environment. We
appreciate our personnel and encourage their professional develop-
ment.
You are invited to enquire concerning employment opportunities to:
Director of Nursing
HUMBER MEMORIAL HOSPITAL
200 Church Street, Weston, Ontario
Telephone 249-8111 (Toronto)
CALGARY GENERAL HOSPITAL
requires immediately
REGISTERED GENERAL DUTY NURSES
This is a modern 1,OOO-bed hospital including a new
200-bed convalescent-rehabilitation section. Benefits
include Pension Plan, sick leave, and shift differen-
tial plus a liberal vacation policy and salary range
$360 - $420 per month commensurate with training
and experience.
Apply to:
Director of Nursing Service
CALGARY GENERAL HOSPITAL
Calgary, Alberta
JANUARY 1967
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recreation
SpecIalize at either the 424 bed Grace Central
HospItal in the new $250 million Detroit Medical
Center or at the 448 bed Grace Northwest Hospital.
(Grace is second largest in terms of admissions in
MIchigan.)
Further your education at nearby Wayne State
University or one ot the many smaller colleges
nearby.
Enjoy your leisure time in the heart of the
cultural and entertainment center of dynamic
DetroIt or enJoy the all-year around sports and
recreatIon of Michigan.
Staft nurses at Grace earn from $500 to $600
per month for days and $514 to $629 for evening
and night duty plus very generous fnnge benefits.
Other pOSItions pay even more. For full informa-
tion contact" Director of Nursing.
GRACE CENTRAL HOSPITAL
4160 John R. Street.
DetroIt. MichIgan 48201
or
GRACE NORTHWEST HOSPITAL
18700 Meyers Road.
DetroIt. MichIgan 48235
IANUARY 1967
ASSISTANT
ADMINISTRATOR
(NURSING)
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To assume full responsibility
for the nursing service functions
of a 1,000 bed teaching hospital,
located in a modern medical
centre, and to coordinate nursing
educafion activities with the ser-
vice functions.
Post Graduate qualifications in
nursing, hospital management,
or business administration; and
administrative experience rela-
ted to the responsibilities of this
position, are required.
The salary level will recognize
the responsibilities of the position
and the qualifications of the ap-
plicant.
Director of Nursing
Service
Required to assist in the ad-
ministration of the Department
of Nursing in directing and
supervising patienf care.
Post Graduate Nursing quali-
fications and experience in
nursing administration or super-
vision, are desired.
Attractive salary and benefits.
Please direct applications to:
Dr. L. O. BRADLEY,
Executive Director,
WINNIPEG GENERAL
HOSPITAL
700 William Avenue,
Winnipeg, Manitoba
Phone Area #204--774-6511
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If you're ready for a change, but
reluctant to make the move, we
have an added incentive-a free
airline ticket. Of course, it isn't
really free-you'll have to take a
position in a modern, progressive,
expanding hospital and you'll
have to live in a mild, sunny met-
ropolitan area, rich in educational
and cultural opportunities. But
that isn't too much to ask, is it?
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PRESBYTERIAN HOSPITAL CENTER
ALBUQUERQUE, NEW MEXICO 811 06
UStarting salary to $555 a month
u500-bed hospital
o Personal orientation program
uLiberal fringe benefits
UContinuing educational programs
=*Career advancement opportunities
uTwo universities
UTwenty minutes from nearby
mountain ski area
EQUAL OPPORTUNITV EMPLOVER
Mail coupon or call collect (505-243-9411, Elt. 219)
Mrs. Susan Dicke. Director of Nurse Recruitment
Presbyterian Hospital Center. Oepartment B
Albuquerque, New Mexico 87106
Please mall me more information about nursing
at Presbyterian Hospital Center and tell me how
I may fly there at your expense.
Name
Address
City
State
School of Nursing
Ve.r of Graduation _Month
.-.-.-....-- ...-....... - ..-...-.-
THE CANADIAN NURSE 71
SCHOOL OF NURSING
WOODSTOCK GENERAL HOSPITAL
Requires the following Faculty
a) Psychiatric Teacher (One).
b) Medical and Surgical Teachers (Two).
Minimum requirement - B. Sc. N_
The above oddifionol staff is required
for New Program.
Apply to:
Director of Nursing Education
WOODSTOCK GENERAL
HOSPITAL
Woodstock, Ontario
SOUTH PEEL HOSPITAL
COOKSVtllE, ONTARIO
A new 450-bed General Hospital, located
12 miles from the City of Toronto. hos
openings for:
(1) GENERAL STAFF NURSES in all d..
partments;
(2) Regiltered Nursing Assistants in all
departments.
For information or application, write to:
Director of Nursing
SOUTH PEEL HOSPITAL
Cooksville r Ontario
KINGSTON GENERAL HOSPITAL
KINGSTON, ONTARIO
Inferesting chonges in our physical planf
ore taking ploce at Kingston Generol
Hospifal. We invife you to join OUr
Nursing Staff and share in providing
qualify care fo our patienfs. We offer
you a basic orientation and an ongoing
educafion programme. Sfarting salary is
dependent on Ontario registration, pre-
parafion and experience. Kingsfon is the
home of Queen's Universify and the
Royal Milifary College and is ideally
located in the Thousand Islands area.
as well as close to the Metropolitan
areas of Monfreal. Toronfo and New
York City.
Apply to:
MISS S. M. BURKINSHAW r
Dirf'ctor of Nursing,
72 THE CANADIAN NURSE
OPERAT1NG ROOM
SUPERVISOR
Postgraduate trained.
For 61-bed well-equipped
hospital.
Apply:
Administrator
WILLETT HOSPITAL
Paris, Ontario
PUBLIC HEALTH NURSES
required for
HEALTH BRANCH
B. C. Civil Service
Positions available for qualified Public
Healfh Nurses in various centres in Brifish
Columbia.
SALARY: $432 - $530 per monfh; car
provided. An opportunity for interesting
and challenging professional service in this
beautiful ond fost-developing Province.
For further information and application
forms, apply to:
The Director, Public Health Nursing,
Deparfment of Health Service. and
Hospitat Insurance, Parliament Building..
VICTORIA, B. C., or to The Chairman,
B. C. CIVil SERVICE COMMISSION,
544 Michigan Street,
VICTORIA, B. C.
COMPETITtON No. 66:281 A
PETERBOROUGH CIVIC HOSPITAL
School of Nursing requires
INSTRUCTRESS (Nursing Arts)
INSTRUCTRESS (Medical.Surgical Area)
New self-contained education building for
school of nursing now open.
Trent Universify is sifuated in Peterborough
For further information write to:
Director of Nursing
PETERBOROUGH CIVIC
HOSPITAL
Peterborough, Ontario
SCHOOL OF NURSING
PUBLIC GENERAL HOSPITAL
Chatham, Ontario
requires
INSTRuaORS
Student Body of 130
Modern self-confained education building
Universify Preparation required with
salary differential for Degree.
For further information,
apply to:
Director, Nursing Education
GRADUATE NURSES
Eligible for regisfrafion in the
Province of Ontario.
Various positions available as SUPER.
VISORS. HEAD NURSES. and GENERAL
DUTY NURSES. Excellent opportunities for
advancemenf in all areos of modern.
newly expanded 1,OOO-bed General Hos-
pital, including O.R. and Recovery, Inten-
sive Care. Emergency, Central Supply.
Medical and Surgical Units.
Please contact:
Director of Nursing
HENDERSON GENERAL
HOSPIT AL
Hamilton, Ontario
REGISTERED GENERAL
DUTY NURSn
For 75-bed active hospital located 70
miles Easf of Saskatoon.
Excellent personnel policies.
Apply:
Director of Nursing Service
ST. ELIZABETH'S HOSPITAL
Humboldt, Saskatchewan
JANUARY 1967
nurses
who want to
nurse
At York Central you can join
an active, interested group of
nurses who want the chance to
nurse in its broadest sense. Our
I 26-bed. fully accredited hospi-
tal is young. and already talking
expansion. Nursing is a profes-
sion we respect and we were the
first to plan and develop a unique
nursing audit system; new mem-
bers of our nursing staff do not
necessarily start at the base salary
of $372 per month but get added
pay for previous years of work.
There are opportunities for gain-
ing wide experience, for getting
to know patients as well as staff.
Situated in Richmond Hill, all
the cultural and entertainment fa-
cilities of Metropolitan Toronto
are available a few miles to the
South. .. and the winter and
summer holiday and week-end
pleasures of Ontario are easily
accessible to the North. If you
are realIy interested in nursing,
you are needed and will be made
welcome.
Apply in person or by mail to the
Director of Nursing.
YORK
CENTRAL
HOSPITAL
RICHMOND HILL,
ONTARIO
NEW STAFF RESIDENCE
!ANUARY 1967
Registered Nurses
AND
Registered
Nursing Assistants
For 300-bed Accredited General
Hospital situated in the pictur-
esque Grand River Valley. 60
miles from Toronto.
Modern well-equipped hospital
providing quality nursing care.
Excellent personnel policies.
For further information write:
Director of Nursing Service
SOUTH WATERLOO
MEMORIAL HOSPITAL
Galt, Ontario
REGISTERED NURSES
250-bed General Hospital, ex-
panding to 400, located in San
Francisco, California. Positions on
all shifts for nurses in Intensive
Care Unit, Operating Room, and
General Staff Duty. Salary range
effective April 1967, $600-$700.
Health and life Insurance, Retire-
ment Program - all hospital
paid. liberal holiday and vaca-
tion benefits. Accredited medical
residencies in Medicine, General
Surgery, Neuro Surgery, Ortho-
pedics, and Plastic Surgery.
For further information write to:
Miss Lois Jann,
Director of Nursing
FRANKLIN HOSPITAL
14th and Noe Streets,
San Francisco, California
THE
NORTHWESTERN
GENERAL
HOSPITAL
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Fu lIy accredited
Progressive 250 bed hospital
Planned expansion to 400 beds
20 minutes to downtown Toronto.
YOUR PROFESSIONAL GROWTH
Planned orientation programme
Continuing inservice education.
BENEFITS INCLUDE-
3 weeks vacation
8 statutory holidays
Cumulative sick leave
Group life insurance
Hospitalization
40 hour week.
HOUSING -
Furnished apartments at reduced rates.
For information contact:
Director of Nursing
NORTHWESTERN
GENERAL HOSPI' AL
2175 Keele St.,
Toronto 15, Onto
THE CANADIAN NURSE 73
WOODSTOCK GENERAL HOSPITAL
Requires
GENERAL STAFF NURSES
ALL DEPARTMENTS
and
O.R. TECHNICIANS
Apply:
Director of Nursing
WOODSTOCK
GENERAL HOSPITAL
Woodstock, Ontario
McKELLAR GENERAL HOSPITAL
requires
Registered Nurses for general Staff. The
hospital is friendly and progressive.
It is now in the beginning stoges of a
$3,500,000 program of expansion and
renovation.
- Openings in all services.
- Proximity to lakeheod
ensures opportunity for
educafian.
University
furthering
For full particulars write to:
Acting Director
of Nursing Service
McKELLAR GENERAL HOSPITAL,
Fort William, Ontario.
ST. JOSEPH'S HOSPITAL
SCHOOL OF NURSING
Hamilton, Ontario
requires
CLINICAL INSTRUCTORS in all Nursing
areas. Well-equipped. modern School of
Nursing. Student enrolment over ]00.
Modern. progressive. BOO-bed Hospital.
Salary commensurate with preparation
and experience.
For further details, apply:
DIRECTOR OF NURSING
74 THE CANADIAN NURSE
PORT COLBORNE
GENERAL HOSPITAL
!'ORT COLBORNE, ONTARIO
ST AFF NURSES
required
For 166-bed hospital within easy driving
disfance of American and Canadian me-
tropolifan centres. Considerafion given for
previous experience obtained in Canada.
Completely furnished apartment-style resi-
dence, including balcony and swimming
pool facing lake, adjacenf to hospital.
Apply:
Director of Nursing
GENERAL HOSPITAL
!'ort Colborne,Ontario
REGISTERED NURSES
For new 100-bed General Hospital in
resorf town of 14,000 people, beaufifully
located on shores of lake of fhe Woods.
Three hours' travel time from Winnipeg
with good transparfation available. Wide
variety of summer and winter sports-
swimming. boofing, fishing, golfing, skaf-
ing. curling, fobogganing, skiing and ice
fishing.
Salary: $372 for nurses registered in
Ontario with allawanæ for experience.
Residence available. Good personnel poli.
cies.
Apply to:
DIRECTOR OF NURSING
KENORA GENERAL HOSPITAL
Kenora, Ontario
OTTAWA CIV1C HOSPITAL
OTTAWA, ONTARIO
This modern 10B7-bed teaching hospital
requires:
REGISTERED NURSES
FOR All SERVICES INQUDING
OPERATING ROOM AND PSYCHIATRY
Excellent salaries. personnel policies and
fringe benefits are available.
Apply in writing to:
B. JEAN MILLIGAN, Reg. N., M.A.
Assistant Director
ST. JOSEPH'S HOSPITAL
LONDON. ONTARIO
Teaching Hospital, 600 beds, new focilifies
requires:
REGISTERED NURSES
REGISTERED NURSING ASSISTANTS
For further information apply:
The Director of Nursing
ST. JOSEPH'S HOSPITAL
London, Ontario
DIRECTOR OF NURSING
EDUCATION
Masfer's degree preferred; fo conduct
basic nursing program and offilliate pro-
gram.
Apply to:
Director of Nursing,
CHILDREN'S HOSPITAL
OF WINNIPEG,
Winnipeg, Manitoba.
ST. THOMAS-ELGIN
GENERAL HOSPITAL
Requires
GENERAL STAFF NURSES
REGISTERED NURSING
ASSIST ANTS
O. R. TECHNICIANS
Modern 395 bed, fully accredifed General
Hospital opened in 1954, with School 01
Nursing. Excellent personnel policies.
O. H. A. Pension Plan. Pleasant progres-
sive industriol city of 22,500.
Apply:
Director of Nursing,
ST. THOMAS-ELGIN GENERAL
HOSPIT Al
St. Thomas, Ontario.
JANUARY 1967
SUNNYBROOK
HOSPIT AL
REGISTERED NURSES
General Duty Nurses on rotating
shifts are needed as port of the
re-organization of Sunnybrook as
a university teaching hospital.
Employment in our Nursing Ser-
vices Department includes:
Metro Toronto Salary Scale
Accommodation at reduced
rates. Full range of fringe
benefits
Three weeks vacation after
1 year
Good location
subway on
grounds.
bus from
to hospital
For additional information,
please write:
Director of Personnel
and Public Relations,
SUNNYBROOK HOSPITAL
2075 Bayview Avenue
Toronto 12, Ontario
ANUARY 1967
POSITIONS ARE AVAILABLE
for
REGISTERED NURSES
with special interest in medical
nursing and rehabilitation of
long term patients.
Salaries recommended by the
Registered Nurses'
Association of Ontario
Inservice educational program-
me developed and
expanding
Residence accommodation avail-
able at a very mod-
erate rate
Transportation advanced, if re-
quested
Apply to:
Director of Nursing
THE QUEEN ELIZABETH HOSPITAL
130 Dunn Avenue
Toronto 3, Onto
REGISTERED NURSES
for General Duty
In modern 20-bed hospital locat-
ed in thriving northwestern On-
tario community. Starting salary
$335 minimum to $400 maxi-
mum for three years' experience.
Board and room in modern
nurses' residence is supplied at
no charge. Excellent employee
benefits and recreational facili-
ties available. Further particulars
on request. Apply giving full
details of experience, age, avail-
ability, etc. to:
Employment Supervisor
MARATHON CORPORATION
OF CANADA LIMITED
Marathon, Ontario
ONTARIO SOCIETY
FOR
CRIPPLED CHILDREN
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Invites applications from Public
Health Nurses who have at least
2 years experience in general-
ized public health nursing, pre-
ferably in Ontario.
INTERESTING AND VARIED
PROFESSIONAL SERVICES
IN AN EXPANDING PROGRAM
INCLUDE:
. an opportunity to work direct-
ly with children, their parents,
health and welfare agencies,
and professional groups
. participation in arranging
diagnostic and consultant cli-
nics
. assessing the needs of the
individually handicapped chjld
in relation to services provided
by Easter Seal Clubs and the
Society.
Attractive salary schedule with
excellent benefits. Car provided.
Pre-service preparation with sa-
lary.
Apply in writing to:
Director, Nursing Service,
350 Rumsey Road,
Toronto 17, Ontario
THE CANADIAN NURSE 75
REGISTERED NURSES
Staff posifions available in acute and
convalescent unit of large General Hospital
located in San Francisco Bay Area. Sfarfing
salary $550 fo $605 plus differenfial. Ex.
cellent benefits.
Apply:
SEQUOIA HOSPITAL
Whipple and Alameda
Redwood City, California
222 BED GENERAL HOSPITAL
requires
STAFF NURSES
REGISTERED NURSING ASSISTANTS
Cornwall is noted for its summer and
winter sporf areas, and is an hour and a
half from both Montreal and Ottawa.
Progressive personnel policies include 4
weeks vacafion. Experience and posf.basic
cerfificafes are recognized.
Apply to:
Ass't. Director of Nursing
(service)
CORNWALL GENERAL HOSPITAL
Cornwall, Ontario
EVENING OR NIGHT
SUPERVISOR
For 70lbed active hospital located 70
miles East of Saskafoon. Salary com-
mensurate wifh experience and qualifica-
tions. Excellent personnel policies.
Apply:
Direclor of Nursing Service
ST. ELIZABETH'S HOSPITAL
Humboldt, Saskatchewan
76 THE CANADIAN NURSE
REGISTERED NURSES
required for
82-bed hospifal. Sifuafed in the Niagara
Peninsula. Transportafion assistance.
For salary rafes and personnel policies,
apply to:
Director of Nursing
HALDIMAND WAR MEMORIAL
HOSPITAL
Dunnville, Ontario
DIRECTOR OF NURSING
Applicafions are invited for the above
position in a modern, 56.bed, fully ac-
credited hospital wifh expansion plans
under active study. Nursing administrafive
educafion and experience desirable.
Salary commensurate with qualifications.
Apply:
Mrs. M. Fearn, Executive Director
THE BARRIE MEMORIAL
HOSPITAL
Ormstown" Quebec
CLINICAL INSTRUCTOR
FOR OPERATING ROOM
required by
ROYAL COLUMBIAN HOSPITAL
School of Nursing,
New Westminster, B.C.
For further information contact
Director of Nursing
THE UNIVERSITY OF
WESTERN ONTARIO
SCHOOL OF NURSING
annOunces
FACULTY POSITIONS
available for the following programmes:
I. A Four-Year Basic Degree ProgrammE
(B.Sc.N.) beginning in September 1966
2. Degree Programme for Graduafe Reg.
istered Nurses.
3. Exponding graduate programmes
(M.Sc.N.).
Enquires are invifed from qualified person!
who are interesfed in Universify teaching
opporfunifies in the School of Nursing of a
rapidly developing Health Sciences Centre.
For information write to:
The Dean, School of Nursing
THE UNIVERSITY OF
WESTERN ONTARIO
London, Canada
REGISTERED NURSES
Positions available in several hospitals
in Easf Cenfral Saskafchewan ranging
from 10 - 75 beds. Saskafchewan Reg-
isfered Nurses' Associafion so lory schedule
and personnel policies in effect.
For further information apply to:
Executive Director
EAST CENTRAL REGIONAL
HOSPITAL COUNCIL
Suite 4, Smith Block,
Yorkton, Saskatchewan
GENERAL DUTY NURSES
and
NURSING ASSISTANTS
Wanfed for acfive General Hospital (125
beds) sifuated in St. Anfhony, Newfound-
land, a town of 2,400 and headquarfers
of the International Grenfell Association
which provides medical care for northern
Newfoundland and the coo sf of labrador.
Salaries in accordance with ARNN.
For further information
please write:
Miss Dorothy A. Plant
INTERNATIONAL GRENFELL ASSOCIATION
Room 701A, 88 Metcalfe Street.
OTTAWA 4. ONTARIO
JANUARY 1967
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GUY'S HOSPITAL
LONDON
TO REGISTERED NURSES Of
ACCREDITED SCHOOLS Of NURSING
If you are visiting Great Britain. why not widen your professional
experience and consider joining the staff at Guy's Hospital?
Appointmenfs for six months are offered in all Branches of general
nursing, in the specialised unifs. and privafe pafienfs wing.
The furnished accommodation is excellent and all modern facilities
are available. The Hospital is ideally situated for exploring London.
Those nurses who are inferested and would like further information,
please write to:
The Matron, Cuy's Hospital,
London, S. E. 1.
giving details of your nursing training. and subsequent experience.
SCHOOL OF NURSING
BROCKVILLE
GENERAL HOSPITAL
Requires
TEACHERS
For the recently approved two year curriculum with
a third year of experience in nursing service. You
will enjoy participating in the development of a
progressive school which emphasizes planned learn-
ing experiences for the students. Theory is taught
concurrent with clinical experience.
Qualifications: Bachelor of Science in Nursing
or Diploma in Nursing Education
or Diploma in Public Health Nursing
Excellent salaries and personnel policies.
You would enjoy living in the attractive "City of
the Thousand Islands" two and one half hours from
Expo 67.
For further information contact:
The Director, School of Nursing
BROCKVILLE GENERAL HOSPITAL
Brockville, Ontario
IANUARY 1967
THE MONTREAL GENERAL HOSPITAL
offers a
6 month Advanced Course in
Operating Room Technique and
Management to
REGISTERED NURSES
with a year's Graduate experience
in an Operating Room.
Classes commence in September and
March for selected classes of
8 students
For further information apply to :
The Director of Nursing
THE MONTREAL GENERAL HOSPITAL
Montreal 25, Quebec
THE CANADIAN NURSE 77
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REGISTERED & GRADUATE
NURSES
Are required to fill vacancies in a modern, centrally
located Hospital. Tours of duty are 7:30 - 4:00, 3:30-
12:00 and 11 :30 - 8:00.
Salary range for Registered Nurses is $382.50 to
$447.50 per month and for Graduate Nurses is
$352.50 to $417.50 per month. We offer a full
range of employee benefits and excellent working
conditions.
Day Care facilities for pre-school children from 3
months to 5 years in age.
Apply in person, or by letter to :
Personnel Manager,
THE RIVERDALE HOSPITAL
St. Matthews Road,
Toronto 8, Ontario.
DALHOUSIE UNIVERSITY
offers
NEW DIPLOMA PROGRAM
in
OUTPOST NURSING
A program extending over two calendar
years has been developed to prepare
graduate nurses for service in remOfe
areas of Northern Canada. Major areas
within fhe cOurse of sfudy will include:
Public health nursing
Complete midwifery
Basic clinical medicine
Insfrucfion will be highly individualized.
!sf year - To be spenf affhe University.
2nd year - To consist of an internship
direcfed by fhe Universify in
selected northern agencies.
Candidates should have complefed at
least one year of professional nursing.
Upon complefion of fhe program students
will receive a Diploma in Public Health
Nursing and a Diploma in Outpast
Nursing.
For further information write to:
Director,
SCHOOL OF NURSING
DALHOUSIE UNIVERSITY
Halifax, Nova Scotia
78 THE CANADIAN NURSE
REGISTERED NURSES
Lutheran General Hospital, Park Ridge, Illinois is a
new 587-bed General Hospital, located in a pleasant
suburb of Chicago.
The hospital is modern with a wide range of services
to patients, including Hyperbaric Oxygen Unit. Low-
cost modern housing next to the hospital is available.
The hospital is completely air-conditioned.
Annual beginning salary is from $6,000 plus shift
differential pay. Regular salary increments at six
months of service and yearly thereafter. Sick leave
and other fringe benefits are also available.
Write or call collect:
Director of Nursing Services
LUTHERAN GENERAL HOSPITAL
PARK RIDGE, ILLINOIS 60068
Telephone: 692-2210 Ext. 211
Area Code: 312
THE WINNIPEG
GENERAL HOSPITAL
Offers the following opporfunify for ad-
vanced preparation to qualified Regisfered
Graduate Nurses:
A SIX MONTH CLINICAL COURSE
in
OPERATING ROOM
PRINCIPLES AND ADVANCED
PRACTICE
The caurse commences in September of
each year. Mointenance is provided, and
a reasonable sfipend is given each month.
Enrolment is limifed to a maximum of
fen sfudenfs.
For further information please
write to:
THE DIREOOR OF NURSING
700 William Ave.
Winnipeg 3
, ..;1:)' f1
"A
<<)
1
.
.
DALHOUSIE
UNIVERSITY
Degree Course in Bosic Nursing - (B.N.)
4 years
A progrom eXfending over four calendar
years leading to the Bachelor of Nursing
degree is offered to candidates with a
Nova Scotia Grade XII sfanding (or equiv-
alenf) and prepares the student for nursing
practice in hospitals and fhe communify.
The curriculum includes studies in the
humanities. nursing and fhe sciences.
Degree Course for Registered Nurses -
(B.N.) - 3 years
A program extending over three ocademic
years is offered to Regisfered Nurses who
wish to obtain a Bachelor of Nursing
degree. The course includes sfudies in
the humanities. sciences and a nursing
specia Ity.
Diploma Courses for Registered Nurses -
1 year
(1) Nursing Service Adminisfrafion
(2) Public Health Nursing
(3) Teaching in Schools of Nursing
For further information apply to:
Director. School of Nursing
DALHOUSIE UNIVERSITY
Halifax, N.S.
JANUARY 196i
UNITED STATES
AFF NURSES Here is the opportunity to further
velop your professionol skills ond knowledge in
, I,OOO-bed medicol center. We hove liberol personnel
licies with premiums for evening and night tours.
Jf nurses. residence, located in the midst of 33
Irural and educational institutions, offers low.cost
using adjacent to the Hospitals. Write for our booklet
nursing opportunities. Feel free ta tell l.S what type
sirian you ore seeking. Write: Director of Nursing,
om 600, University Hospitals of Cleveland, University
,cle, Clevelond, Oh io 44-06 15-36-1 G
gistered Nurse (Scenic Oregon vacation play.
:>und, skiing, swimming, booting & cultural
ents) for 295-bed teoching unit on compus of
.ive-rsity of Oregon medical school. Salary starts
$525. Poy differentiol for nights ond evenings.
liberal policy for advancement, vocations, sick
leove, holidoys. Apply: Multnomoh Hospitol, Port-
lond, Oregon. 97201. 15-38-1
Staff Nurses: Live with your family in on attractive
2 bedroom furnished home for $55 per month,
including utilities, and work in a suburban Cleve-
lond hospitol. Storting solory ronge $420 - $445
with 6 and 12 month increments. Excellent transpor-
tation to hospital door. Outstanding schools and
cultural opportunities. Apply: Director of Nursing
Service, Sunny Acres Hospitol, 4310 Richmond Rood,
Clevelond, Ohio 44122. 15-36-1 E
GRADUATE NURSES Wouldn't you like to work
ot 0 modern 532-bed ocute Generol Teoching Hos-
pitol where you would hove: (0) unlimited oppor-
tunities for professional growth and advancement,
(b) tuition poid for odvonced study, (c) storting
solory of $429 per manrh (to rhose with pending
registration as well), d) progressive personnel poli.
ROYAL VICTORIA HOSPITAL
SCHOOL OF NURSING
MONTREAL, QUEBEC
POSTGRADUATE COURSES
1.
(a) .Six month clinical course in Obstetrical Nursing.
Classes - September and March.
Two month clinical course in Gynecological Nursing.
Classes following the six month course in Obstetrical
Nursing.
Eight week COurse in Care of the Premature Infant.
(b)
(c)
2. Six month course in Operating Room Technique.
Classes - September and March.
3. Six month course in Theory and Practice in Psychiatric
Nursing.
Classes - September and March.
For information and details of the courses, apply to:
DIRECTOR OF NURSING
ROYAL VICTORIA HOSPITAL
Montreal, P.Q.
\NUARY 1967
I
cies, (e) a choice of areas? For further information,
write or call collect: Miss Louise Harrison, Director
of Nursing Service, Mount Sinai Hospital, University
Circle, Clevelond, Ohio 44106. Phone SWeetbrior
5-6000. 15-36-1 D
STAFF NURSES: University of Woshington. 320-bed
modern, expanding Teaching and Research Hospital
located on campus offers you an opportunity to
join the staff in one of the following specialties:
Clinical Research, Premature Center, Open Heart
Surgery, Physical Medicine, Orthopedicts, Neurosur-
gery, Adult and Child Psychiotry in addition to
the Generol Services. Salary: $501 to $576. Unique
benefit program includes free University courses after
six months. For information on opportunities, write
to: Mrs. Ruth Fine. Director of Nursing Services,
University Hospital, 1959 N.E. Pacific Avenue,
Seottle, Woshington 98105. 15-48-2D
UNIVERSITY OF
BRITISH COLUMBIA
School of Nursing
DEGREE COURSE IN BASIC
NURSING
DEGREE COURSE FOR
GRADUATE NURSES
Both of these courses lead to the
B.S.N. degree. Graduates are pre-
pared for public health as well as
hospital nursing positions.
DIPLOMA COURSES FOR
GRADUATE NURSES
I. Public Health Nursing.
2. Administration of Hospital
Nursing Units.
3. Psychiatric Nursing.
For information write to:
The Director
SCHOOL OF NURSING
UNIVERSITY OF B.C.
Vancouver 8, B.C.
NOVA SCOTIA SANATORIUM
KENTVlllE, N.S.
Offers to Graduate Nurses a
Three-Month Course in Tubercu-
losis Nursing, including Immu-
nology, Prevention, Medical and
Surgical Treatment.
For information apply to:
Director of Nursing
NOVA SCOTIA SANATORIUM
Kentville, N.S.
THE CANADIAN NURSE 79
..........
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...++++++.
.+++++++++
...+....+.
.....
Turns
consume
93 times their
own weight
in excess
stomach
acid!
Laboratory tests show Tums neu-
tralize 93 times their own weight
in excess stomach acids, and that
they maintain a balanced level for
long periods, too. Tums go to work
in 4 seconds on gas, heartburn and
indigestion. And they taste pleas-
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cost so very little. Those are the
facts. So next time your tummy
gives you a turn, give Tums a try.
They're worth their weight in gold !
4lU
$.J
FOR THE NURSE WHO
DOESN'T HAVE EVERYTHING
think how fasttheyll work
on your tummy upsets!
ASSISTOSCOPE ::
'-
When your friends start
"fishing" for what to give
you this Christmas, hint
to them how much you
would like your personal
lightweight stethoscope.
ASSISTOSCOPE* - designed with the nurse in mind.
Regularly $12.95, your Christmas stethoscope will cost
you only $9.85 in your choice of white or black tubing.
This offer expires December 24th.
Also available in spe-
cial sister model which
fits easily under the
coif.
Order from t
\AI
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N
U
!.
I
M IIONTRUL 21 QUElIC
2 _ 67 .TRADE MARl(
ASSISTOSCOPE*
Made in Canada
80 THE CANADIAN NURSE
Index
to
advertisers
Jan uary 1967
Abbot Laboratories Ltd.
Ames Company of Canada Ltd.
American Sterilizer Company
Bland Uniforms Limited
Government of Canada, Dept. of Labour
Canadian University Service Overseas
M. J. Chase Co. Inc.
Charles E. Frosst & Co.
Hollister Limited
Lakeside Laboratories (Canada) Ltd.
Lewis-Howe Company (Turns)
C.V. Mosby Co.
T.M. Pharmaco (Canada) Ltd
J.T. Posey Company
The Queen's Printer
Reeves Company
Uniforms Registered
United Surgical Corporation
Warner-Chilcott Labs. Co. Ltd.
White Sister Uniforms Inc.
Winley-Morris Co. Ltd.
Advertising
Manager
Ruth H. Baumel,
The Canadian Nurse
50 The Driveway,
Ottawa 4, Ontario
Advertising Representatives
Richard P. Wilson,
219 East Lancaster Avenue,
Ardmore, Penna. 19003
Vanco Publications,
170 The Donway West,
Suite 408, Don Mills, Ont.
Member of Canadian
Circulation Audit Board Inc.
Cover IV
I J
2
9
24
57
10
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80
20, 21
17
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Cover III
17
57
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80
I3E:J
JANUARY 1%:
February 1967
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The
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nursing in the USSR
drug addiction
nurse and pharmacist
- partners
estrogen and the menopause
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are pleased to co-operate
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NURSES STATION
at the
MAN IN HEALTH PAVILION
exp o 67 :W
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I
W.B. SAUNDERS COMPANY
Philadelphia and London
Saunders Texts - to enrich and
expand your knowledge of nursing
. . .
Kron-Communication in Nursing
By THORA KRON, R.N., B.S., formerly St. Luke's Hospital of Nursing.
A New Book! From the author of Nursing Team Leadership, here
is a practical guide for the nurse on how to write, speak - even
nod! - with meaning. It skillfully shows how to have your thoughts
and ideas "come accross." Mrs. Kron provides specific, how-to-do
it information for achieving improved communication: how to
become an intelligent listener - how to give a demonstration -
how to make a speech - how to disagree agreeably - how to
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points out common difficulties and makes concrete suggestions for
improvement. The principles given throughout the text are sum-
marized at the end. 244 pp., iIIus., $4.05. Just Published!
The Nursing Clinics of North America
The Nursing Clinics fill an urgent need by providing a single and
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and techniques. The forthcoming March issue contains two impor-
tant symposia: The Nurse and the Law, with Jane C. Donahue, R.N.,
LL.B., as Guest Editor, and Radiation Uses and Hazards, with Eliza-
beth H. Boeker, M.S.P.H., as Guest Editor. The 16 full-length, well-
written articles range from "Professional Liability Insurance for
Nurses" to "Nursing Care in Radium Therapy." As in every issue of
Nursing Clinics, every article is written by an authority in the field,
and the topics discussed are those suggested by subscribers. Every
issue (4 per year) contains about 160 pages with no advertising,
and is bound between hard covers. Annual subscription (4 issues)
only. $13.00. Student Rate: $10.80.
Howe-Nutrition for Practical Nurses
By PHYLLIS S. HOWE, B.S., M.E., Contra Costa College and Diablo
Valley College. This up-to-date New (4th) Edition provides the
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therapy, plus selection and care of food. Discussions range from
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foods. Exercises are included at the end of most chapters. 302 pp.,
iIIus., $4.05. New (4th) Edition - Just Published!
Dennis-
Psychology of Human Behavior for Nurses
By Lorraine Bradt Dennis, B.S., R.N., M.S., Marymount Junior Col-
lege. In the thoroughly revised and expanded New (3rd) Edition!
of this delightful book, Mrs. Dennis has achieved much more than
just another textbook. As well as providing an excellent practical
introduction to psychology, this books helps the student nurse to
find out what she really wants to know: Why do people behave
as they do? How can I study most effectively? What can I do
about my problems? Mrs. Dennis gives a clear and balanced
picture of psychology. She discusses genetics and early develop-
ment; learning, behavior, and personality; defense mechanisms;
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Guide available. 289 pp., iIIus., $5.40. New (3rd) Edition - Just
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Canadian Representative: Me Ainsh and Company, Ltd. 1835 Yonge St., Toronto 7
BRUARY 1967 THE CANADIAN NURSE 1
so soft. . . so soothing
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SOME STYLES ALSO AVAILABLE IN COLORS. . SOME STYLES3/í'-12 AAAA.E. $15.9510 $20.95
For a complimentary pair 01 white shoelaces, lolder showing all the smart Clinic styles, and list 01 stores selling them, write:
THE CLINIC SHOEMAKERS. Dept.CN-2.1221 Locust St. . St. Louis, Mo. 63103
2 THE CANADIAN NURSE FEBRUARY 1967
The
Canadian
Nurse
A monthly journal for the nurses of Canada published
in English and French editions by the Canadian Nurses Association
Volume 63, Number 2
February 1967
27 A Glimpse of Nursing in the USSR H. K. Mussallem
34 Estrogen Replacement at Menopause D.C McEwen
38 Estrogen and the Menopause .. J. Blanchet
40 Nurse and Pharmacist - Partners J. L. Summers
45 Tumors of the Skin P. J. Fitzpatrick
48 Radiation Therapy for Skin Cancer ... D. Martyn
The views expressed in the various articles are the views of the authors and do not
necessarily represent the policies or views of the Canadian Nurses' Association.
4 Letters
7 News
18 Names
21 Dates
Cover photo courtesy of the USSR Embassy
Executive Director: Heten K. Mussallem .
Editor: Vlrglnta A. Llndabury . Assistant
Editor: Glennts N. ZUm . Editorial Assistant:
Carla D. Penn . Circutation Manager: Pier-
rette Hotte . Advertising Manager: Ruth H.
Baumel . Subscription Rates: Canada: One
Year, $4.50; two years, $8.00. Foreign: One
Year, 15.00; two years, 19.00. Single copies:
50 cents each. Make cheques or money orders
pa\able to The Canadian Nurse. Change of
Address: Four weeks' notice and the otd
address as well as the new are necessary. Not
responsible for journats lost in mail due to
errors in address.
(i:) Canadian Nurses' Association. 1966
:BRUARY 1967
23 In A Capsule
25 New Products
51 Books
54 Films
55 Accession List
Manuscript Infonnatlon: "The Canadian
Nurse" welcomes unsolicited articles. AU
manuscripts shoutd be typed, doubte-spaced,
on one side of unruled paper leaving wide
margins. Manuscripts are accepted for review
for exclusive publication. The editor reserves
the right to make the usual editorial chanl(es.
Photol(raphs (glossy prints) and graphs and
diagrams (drawn in india ink on white paper)
are welcomed with such articles. The editor
is not committed to publish aU articles sent,
nor to indicate defimte dates of publication.
Authorized as Second-Ctass Mail by the Post
Office Department, Ottawa, and for payment
of postage in cash. Postpaid at Montreal.
Return Postage Guaranteed. 50 The Driveway.
Ottawa 4. Ontario.
"The menopause is definitely
obsolete today."
This statement is from the pen
of Robert A. Wilson, M.D., one of
the best known proponents of
estrogen replacement therapy for
menopausal and postmenopausal
women.
Dr. Wilson and his group regard
the menopause as a deficiency
disease, rather than as an inevitable
and irreversible condition. They
believe it requires replacement
therapy with hormones, just as
diabetes mellitus requires insulin,
and hypothyroidism, thyroid.
Not all physicians agree with Dr.
Wilson and his colleagues. Some
strongly oppose the use of sex
hormones to relieve menopausal
symptoms. They defend this
conservative position by saying that
most of these symptoms result
from psychic, rather than physical
causes, and that the loss of female
hormones at middle life is a normal
phenomenon to which the body
will adjust.
Other physicians assume a
moderate position, agreeing that
hormone replacement is warranted
when the vaginal cell count reveals
estrogen deficiency, or when
menopausal symptoms, such as hot
flashes, backache due to
osteoporosis, etc., become
distressing to the patient.
Many women, aware of the
present controversy surrounding
this topic will direct their questions
to nurses. We can answer these
questions objectively only if we
have all pertinent facts. For this
reason, we asked two gynecologists
to present the pros and cons of
estrogen replacement therapy.
Dr. Donald C. McEwen, in
"Estrogen Replacement Therapy at
Menopause," claims that one
woman in three suffers from ovarian
deficiency and should be given
estrogens for the balance of her life.
Dr. Jean Blanchet, in "Estrogen
and the Menopause," takes a more
conservative approach. He believes
that only a small percentage of
menopausal patients have symptoms
that warrant hormonal therapy.
Whether or not the menopause
becomes "obsolete" in future is not
something that we can predict.
However, with society's stress on
youth and youthfulness it seems
likely that we will hear more from
the proponents of estrogen
replacement therapy in the future.
THE CANADIAN NURSE 3
letters
{
Letters to the editor are welcome.
Only signed letters will be considered for publication
Name will be withheld at the writer's request.
Recommended reading
Dear Editor:
We were interested in the review of
Joyce Travelbee's Interpersonal Aspects of
Nursing (December 1966). Our first-year
students have been discussing material
from this text frequently in their course in
nursing fundamentals and we have found
the book has helped them to think and
understand more about nursing, human
beings, and human experiences such as
illness and suffering. Although there are
a few deficiencies in the text, we believe
that these are greatly outweighed by its
value in assisting nursing students "to
achieve helping relationships with others."
- Sister Patricia Marie, (Mrs.) B. Jones,
L. Devereux, and (Mrs.) S. Dunning,
Teachers of Fundamentals of Nursing, St.
Joseph's School of Nursing, London, On-
tario.
Dear Editor:
I would like to recommend a book that
I believe every nurse should read and
which, I hope, she in turn may persuade
just one doctor to read.
The name is, In Search of Sanity, by
Gregory Stefan, and is published by the
University Books, New Hyde Park, New
York.
Those nurses who have read it say it is
unbelievable. It is a very easily read. book
and 1 believe it is a very fitting successor
to A Mind that Found Itself, by Clifford
Beers, the old classic that did so much to
change mental hospitals.
Most book stores in large cities will order
it: Book-of-the-Month will order it; and
it is offered at a much cheaper price by
The American Schizophrenic Foundation,
Ann Arbor, Michigan, if one is a member.
- (Mrs.) Marion Palmer, Alberta.
No criticism
Dear Editor:
In your November 1966 issue there was
an interesting letter from a distressed
reader regarding her obstetrical care in
an Ontario hospital with a comment from
a Halifax nurse stating: "I don't know
what hospitals are putting out for nurses
these days."
Recently, I had the privilege of enter-
ing a modern obstetrical hospital in Hali-
fax. The attention and treatment I received,
from the first moment I entered the hos-
pital with my suitcase, until I left with my
4 THE CANADIAN NURSE
firstborn son, was the happiest experience
of my life, and I cannot honestly criticize
any phase of my hospitalization.
My admission was quickly, quietly, and
efficiently performed by a student nurse,
who first introduced herself, and explained
each procedure before she began the rou-
tine preparations. She took the time to help
me with the breathing exercises with each
labor pain, thus reinforcing the instructions
I had received from my doctor prenatally.
On transfer to the waiting or labor room,
I received friendly, professional interest
and care from both students and supervisor.
At no time during the waiting period was
there evidence of confusion; therefore, a
feeling of confidence was transmitted to
me and no panic or fear resulted. The
case room nurse took the time to visit
several times during the long night and
informed me of my progress. When I was
finally admitted to the labor room, I felt
the staff were friends as well as capable,
well-trained professional personnel.
The postpartum and nursery care in this
hospital were of the same high calibre. My
questions regarding the baby's progress
as well as my own were quickly answered.
The staff certainly displayed patient in-
terest during my hospital stay.
After leaving the hospital, I felt sorry
that I had received my training 15 years too
soon, when the emphasis was on nursing
service, with nursing education second. I
believe that students today are receiving
better education. They are given the op-
portunity to provide nursing care, instead
of orderly, maid or technician duties.
J enjoy the articles published on hospital
nursing. However, J would like to see some
articles on public health nursing. - A
Public Health Nurse, Nova Scotia.
Obstetrics for men
Dear Editor:
I am writing to commend you on the
article "Why Not Obstetric Nursing For
Male Students?" (October t966). The
article was short but presented a good ar-
gument in favor of obstetrical training for
male nursing students. The same desires
that bring women to nursing also bring
men and the same opportunities for train-
ing should be available to both. I believe
that having men in obstetrics could pos-
sibly lend a sense of stability and security
to childbirth for many mothers. - Marsha
Smith, S.N., Providence School of Nursing,
Sandusky, Ohio.
University education I
Dear Editor:
After reading Miss Margaret Steed's arti-
cle "A Goal for the Future," (December
1966) we would like to express our view
points.
First, we found the article very interest
ing. We really appreciated Miss Steed'!
analysis of the different roles in the nursinl
profession. Rather than being based or
quantity, as in the past, nursing care will
in the future, be viewed more from the
aspect of quality. This will provide a ne\\
concept of nursing service - a team work
ing together, centered on the needs of the
patient.
For this, the hospital administrator wi!
have to be well informed of the necessit}
to employ and to utilize the work potentia'
of the two different <:ategories of nurses
We questioned the guidance which shoule
be given to candidates for either nursin!
course. Students must know exactly the
kind of role for which they will be educ.
ated and the opportunities they will have
to pursue their studies. We foresee hoy,
difficult it will be for a diploma nurse
to be accepted in a baccalaureate program
after following a non-credit nursing course
Though it may be a distant goal, we
should prepare the public, teachers, and
students, to participate in the reorganiza' i
tion of the nursing profession.
Miss Steed really opened the way, and
we are looking forward to more article
in the same light. - Nicole Lambert, Gi.
neUe Lefebvre and Louise Poirier, 4th
year students in the baccalaureate pro
gram, Institute Marguerite d'Youville.
Montreal.
Dear Editor:
J want to congratulate Miss Margaret
Steed on her very fine article, "A Goal
for the Future" (December, 1966).
I have read this article with much in-
terest and believe that she has made many
comments which present her true thoughts
on nursing at the present time.
In the section "Education for Practice,"
which is well outlined, she presents facts
that should be a stimulus to many young
nurses who wish to map out a goal for
their future. In the paragraph "Distinctions
in Role and Practice," she has endeavored
to bring out the full meaning of the im-
portance of the nurse in practice. I was
very interested in her comment on team
nursing.
The final paragraph, entitled "The Way
(Continued on page 6)
FEBRUARY 1967
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THE CANADIAN NURSE 5
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letters
(Continued from page 4)
Ahead," is brief, concise. and very thought
provoking.
I will recommend this article to be read
by all the students and I am very happy
that she has taken her pen and com-
posed such a splendid article. - Rahno
M. Beamish, Director of Nursing, Kit-
chener-Waterloo Hospital. Kitchener. Onto
Dear Editor:
The December issue, which describes bac-
calaureate education, contains information
which is of great value for the recruitment
and dissemination of information to the
members of the profession.
We were a little disappointed with the
writeup given to Mount Saint Vincent Uni-
versity. When the original draft was sent
for our review and correction in September,
we made several changes. Yet, the uncor-
rected draft appeared in the journal. We
bring this to your attention knowing that
THE CANADIAN NURSE, as the official organ
of the Association, endeavors to publish
accurate and up-to-date information.
We look forward to each new edition uf
the journal for the stimulating and varied
articles it contains. - Sister Jean Eudes,
R.N., M.S., Director of Nursing.
The correct description of Moullt Sailll
Vincent Ulliversity is provided here for the
benefit of readers. - The Editors.
Mount Saint Vincent University is the
only independent women's college in Cana-
da. It is a Catholic institution for the
higher education of women and is cond-
ucted by the Sisters of Charity. Located ill
the village of Rockingham, about 20 min-
utes from downtown Halifax by car, the
campus overlooks Bedford Basin. The Uni-
versity is growing rapidly; a new tower
residence and a Student Union building
hm'e been completed recently. Plans are
under consideration for a new academic
building with adjacent professional build-
ings. Sister Jean Eudes, Director of the
School of Nursing, is responsible to the
Academic Dean who, in turn, reports
directly to the President of the University.
The basic nursing program is a four-
year, integrated program leading to a
Bachelor of Science in Nursing (B.Sc.N.)
degree. Mount Saint Vincent University
was the first university in Nova Scotia to
offer an integrated nursing degree pro-
gram. The course includes three summer
sessions. Hospital practice is given in Hali-
fax hospitals and health agencies and is
under the direct supervision of the Uni-
versity nursing faculty.
A degree program is also open to reg-
istered nurses who have completed one-
year university courses in a nursing special-
ty. The nurse who registers in this program
is required to complete 10 courses i,
science and liberal arts subjects. The pro
gram, instituted to meet a pressing need fo
nurses with degrees in administrative all.
teaching positions in Nova Scotia, will b
offered for a limited time. No certificat
courses are m'ailable.
Admission requirements to the basic 4
year integrated program include Senio
Matriculation (Nova Scotia grade 12) wit
certain specific high school subjects. A ne}
tower residence with single room accom
modation is available on campus and st"
dents may live in if they so desire. Marrie.
women may apply, and, although the UIII
}'ersity is primarily for women, men ma
apply for certain courses.
A bout 20 students are admitted to eac.
new class. It is anticipated that the ScllOC
will enlarge its facilities. Illterested cand.
dates should write to the Director, Schoc
of Nursing, Mount Saint Vincent Unive,
sity, Halifax, N.S.
"Grumps!"
Dear Editor:
Why is it that you always publish letter
saying what a good magazine you have
Doesn't anyone ever say anything critical
Every issue it's "bouquets" and "COlT
pliments." Why don't we ever see "gal
bage" and "grumps"?
Maybe it's because readers like myself
who see plenty to criticize, get in the hab
of tossing your magazine into the wast
basket and turning to the funny pap::rs fo
our amusement.
Not that THF CANADIAN NURSE isn't amu
ing - at least to a certain extent.
The bombastic. amateur-psychologist pros
is really quite a laugh, as long as one doesn
read too much of it or take it too seriousl)
Take this. for a representative exampl
from your last issue:
"An analysis of the aspects of the nursin
proces
as related to patient care reveaJ
a range of activities extending along
continuum from the simplest to the mOl
complex." In other words, in treating p,
tients, a nurse has easy jobs and har
ones.
You've been preaching higher educatio
for some time - in fact it seems to be th
major theme of your magazine - but
Miss Margaret Steed's article (which
quoted from) is an indication of what hal
pens after higher education, then heave
preserve us from it.
I have one more grump. One gels ver
tired of seeing, hearing, and reading abol
professionalism, and what behavior can b
classified as professional, and is nursing
profession or is it not. A nurse is a nurs.
and whether she belongs to a profession (
a labor force, she's got to do the sam
things when she goes to work. What i
fact you're talking about is status; which
to say, you're encouraging snobbery, n(
professionalism. - Sharon Johnston. R.N
Montreal, Quebec.
FEBRUARY 196'
news
ore Cooperation
:MA-CNA-CHA
The Canadian Medical Association has
leen asked to form a steering committee
o prepare for a conference on Hospital-
.tedical Staff relationships. The CMA
viii invite the Canadian Nurses' Associa-
ion and the Canadian Hospital Association
o name members to the committee.
The main object of the conference would
Ie to explain the place and role in the
lospital of administrative personnel, med-
cal staff, and nursing staff, and to em-
,hasize the relationship between the three.
,ointing out the essential need for com-
Ilete understanding and cooperation to
Irrive at the desired result of more ef-
icient operation to produce the best quality
If patient care.
The conference was suggested by a joint
'ommittee of the CHA, CMA, and CNA at
, meeting in December, 1966.
The joint committee has also recom-
nended that the three national associations
Ie given the opportunity to participate in
ach other's annual or biennial meetings.
)r. L.O. Bradley, of the CHA, stated that
here is very little cross representation at
mnual meetings of either the national
)r the provincial associations and that
vhen such representation existed it was
.eJdom that the representatives were given
In opportunity to report the activities of
heir associations or to point out the pro-
Ilems that may exist between the organiza-
ions.
,tudy on Non-Nursing
\ctivities in H.C.
"In determining the number of hours of
mrsing care per patient day, many hos-
litals do not exclude the time spent by
mrsing staff performing duties that are
110re correctly the function of other depart-
l1ents."
This is the conclusion of a joint com-
l1ittee of the Registered Nurses' Associa-
ion of British Columbia and the B.c.
Hospital Association who have recently
'ompleted an investigation of some of the
ifeas in which nurses assist. The commit-
ee consulted representatives of dietary,
lousekeeping, pharmacy, laboratory, x-ray
md social service and have published a
.ix-page booklet outlining non-nursing
juties that nurses are called on to assume
n these areas.
The committee has recommended that
'each hospital give serious consideration
o the question of whether nursing person-
FEBRUARY 1967
RN is Expo 67 Hostess
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This Pdtient at the Montreal Protestant
Hospital is being taken on a verbal tour
of Expo 67 by a hostess who is quite at
home at the hospital bedside. Barabara F.
Stewart, a graduate of The Montreal Gen-
eral Hospital and the McGill School for
Graduate Nurses. is one of the Expo 67
hostesses who is presently informing North
Americans about the coming Exposition.
Miss Stewart, who speaks English,
French and Italian fluently, was employed
with the Montreal Branch of the Victorian
,
.
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Order of Nurses prior to joining the Expo
staff. Her wide professional experience at
hospitals in Montreal, Atlanta, Georgia,
Lausanne and Geneva, Switzerland, and
her travels in 16 other countries give her
a valuable background for meeting the
persons of various ethnic groups who will
attend Expo, April 28 to October 27.
"Being hostess at Expo is a once-in-a-
lifetime event," says Miss Stewart. "When
it is over, I plan to return to nursing,
since it is my-true métier."
'.
nel are being utilized to the best advantage,
and when nursing personnel must be as-
signed non-nursing duties, the time so
spent be subtracted when computing the
actual nursing time being spent on nursing
care."
The committee recognizes that problems
may exist in other areas, such as clerical,
porte ring, messengering, and so on, and
will continue their investigations into these
areas at a later time.
SRNA Prepares Guide
for Refresher Courses
The Saskatchewan Registered Nurses'
Association released a new 12-page Guide
for Refresher Courses for lnactil'e Nurses
in December, 1966. The booklet will be
used as a guide to establish programs to
help inactive nurses return to nursing.
The booklet was prepared by the SRNA
Committee on Nursing Service. Nurses who
have not been engaged in nursing for a
period of five years or longer are required
to have a refresher course before returning
to practice, and the SRNA has undertaken to
give direction and help with the organization
of sU'ch a program through this means. The
association will also assist in finding suitable
staff to carry out the program to help in-
active nurses return to nursing.
The Guide recommends that hospitals of
not less than 30 beds and subject to appro-
val by the SRNA may set up programs. Fees
paid for the course would generally make the
programs self-supporting. The length of the
experience would depend on the needs of the
individual, but a minimum of 120 hours of
selected and supervised practice over a
THE CANADIAN NURSE 7
news
period of not more than 6 weeks is suggest-
ed. Approximately 30 hours of theory should
be correlated with the practice.
Guidelines for course content are also
included in the booklet.
United Nurses of Montreal
Seek Accreditation
The leg31 counsel for the newly-organized
United Nurses of Montreal, Mr. Phil Cutter,
has announced that the UNM will seek to
obtain accreditation from the Quebec
Labour Relations Board to negotiate as
bargaining agent for the 28 Montre31 hos-
pitals in which English-speaking nurses are
in the majority.
The gener31 meeting, in setting up the
constitution, stipulated that 311 nurses who
are English-speaking members of the ANPQ
could join the UNM. In fact, the UNM
was founded following a meeting of the
English-speaking chapter of district 11 at
which 1,200 nurses resolved to form a union
to negotiate on working conditions.
At a meeting of some 600 nurses on
December 14, Miss Moyra Allen, instructor
at the McGill School for Graduate Nurses
and president of the English-speaking
chapter of District 11 of the Association of
Nurses of the Province of Quebec, was
elected president of the UNM. Other offi-
cers elected were: Miss Terry MacMillen,
vice-president; Miss L. Short, secretary; Miss
C. Mutmuir, treasurer; and Misses T. Ni-
chols, M. Powers, and A. H31I, directors.
At present the UNM has 31ready recruited
a majority of the approximately 4,800
English-speaking nurses who work in the
Montreal region.
Another group of nurses, the Metropoli-
tan Association of Nurses, was formed in
Montre31 at the end of November, 1966,
and is 31so seeking accreditation from the
Labour Relations Board.
Nurses Await Satisfactory
Negotiations with Employers
Ontario public he31th nurses in the coun-
ties of Halton, Stormont-Dundas-Glengarry,
and Peel are still awaiting satisfactory
outcomes to their negotiations with
employers.
In Halton County, the nurses returned
to work on November 7th, with the verbal
understanding that negotiations would start
immediately on their return. On November
23 the nurses learned that the Council had
back-tracked on its promise. The County
Council announced that it would not nego-
tiate with the nurses until they had become
certified under the Labour Relations Act.
The H31ton County public health nurses
are presently considering alternative courses
8 THE CANADIAN NURSE
of action. They have no immediate plans
for certification.
In the United Counties of Stormont-
Dundas-Glengarry, the public he31th nurses
returned to work on December 19. three
months after handing in their resignations
when employers refused to negotiate sala-
ries and working conditions with them. They
returned to work with a written promise
that a negotiating committee would be
established, and that the board was prepared
"to negotIate in good faith" with them.
At press-time, no employer-employee ne-
gotiations had been initiated.
In Peel County, which has 31so been grey-
listed by RNAO, public health nurses are
awaiting the report of a conciliator, who
was appointed in November by the Ontario
Labour Relations Board. It is probable that
a conciliation board will be set up as a
recommendation of this report. According
to RNAO News, "the ability of Peel County
Board of Health to negotiate in good faith
has not yet been demonstrated and the
situation is becoming criticaL"
"No Smoking" Literature
For Bedside Tables
A joint committee of the Canadian Med-
ical Association, the Canadian Hospital
Association and the Canadian Nurses' As-
sociation suggested that the three associa-
tions should support the CMA campaign
to publicize the harmful effects of smok-
ing.
At a meeting early in December the com-
mittee agreed that the CMA, working with
the Department of National Health and
Welfare, was the appropriate body to notify
the public of the health hazaJd from smok-
ing.
It was also suggested that the CHA
could recommend to hospitals that a notice
prepared "by the Department of National
Health and endorsed by the CMA and
CHA be placed on all bedside tables in
hospitals.
Hospital Fringe Benefits
Below National Averagt>
In t 965, Canadian hospitals paid an
average of $689 in fringe benefits for each
employee. However, this was barely half
the national average of $ t ,350 per employee
of other Canadian industries.
These figures were disclosed in the
December issue of Hospital Administration
in Canada, which pointed out that 20.8
percent of total hospital payroll costs
went toward fringe benefits. The overall
national average of fringe benefits to pay-
roll is 25.2 percent.
According to the article, the highest
percentage of the fringe benefits given
to hospital employees was for paid time
off work. This was much higher than for
any other group. Paid time off work in-
c1udes vacation pay, holidays with pa}
rest periods and coffee breaks, paid tim
off for death in the family, jury and militar
duty.
Hospitals rank very low in percentag
of payroll benefits devoted to unemplo}'
ment and workmen's compensation and i
contributary pension and other welfar
programs in comparison to the nationa
average.
Hospitals ranked higher in other non
cash benefits, such as cafeteria losse!
medical supplies to employees, parkin
education, and laundry services.
The article was based on a study b
The Thorn Group Ltd., managemer
consultants, Toronto. This was the firm'
sixth report on "Employer fringe benef]
costs in Canada," but the first time th
hospitals were included in the survey.
National Ht>alth and Welfare
The Year in Review
The year 1966 was a year of hand
across the sea and expanded social secunt
across the nation for the Department c
National Health and Welfare.
On the international scene, the Emel
gency Health Services Division sent I
emergency hospitals to Viet Nam and DJ
Joseph W. Willard, Deputy Minister (]
Welfare, was elected chairman of th
Executive Board of UNICEF.
In the field of social security, the newe!
development was the announcement of th
Guaranteed Income Supplement, whic
will provide up to $360 a year to abot
900,000 Old Age Security pensioners wit
modest or no other income.
The major expansion of the department'
health facilities was completion of th
Environmental Health Centre in Oltaw
opened officially in October by the: M
nister, Hon. Allan J. MacEachen. The ne\
building accomodates laboratories and 01
fices of the Occupational Health Divisior
the Public Health Engineering Divisio
and the Consultant in Aerospace Medicinf
The Medical Care Act was passed b
Parliament at the end of the year and wil
become operative not later than July I
1968. The provisions of this statute wer
based on four principles outlined by th
Prime Minister in July, 1965, when he an
nounced the government's intention 10
make federal contributions for provinciall
administered medical care programs avaï
able to the provinces. For provinces t,
benefit from the federal program, provin
cial plans must provide comprehensiv
physicians' services to all residents of th
province without regard to age, abilit
to payor other circumstances. Further
more, the Act empowers the governmen
under stated circumstances to include add
tional health services. Provincial program
must be publicly administered and bene
(Continued on page n
FEBRUARY 196:
Blands of Montreal
FEATURE STYLE, COMFORT AND LONG WEAR
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:EBRUARY 1%7
THE CANADIAN NURSE 9
\;\'ORKSHOPS FOR
DIRECTORS AND
D
ASSIST ANT DIRECTORS
Six regionol workshops for directors or ossistont directors of nursing service in hospitals
will be conducted in 1967. The topic: Improvement of Nursing Service in Hospitals Through
the Problem-Solving Method.
The workshops aim at stimulating directors and assistant directors of nursing service to use
the problem-solving approach in the administration of nursing services. Key speakers will
discuss techniques of problem-solving. Major problems in nursing services in Canada will be
discussed. n.rough group work and case study methods skills in problem-solving will be
developed.
Two workshops will
Region
Atlantic
West
And four in the Fall:
Region
Ontario
Mid-West
Ontario
Quebec
be held in the Spring:
City
Halifax
Vancouver
Dote
April 11-14, 1967
May 2-5, 1967
City
Toronto
Regina
London
Quebec City
Dote
October 17-20, 1967
October 24-27, 1967
November 7-10, 1967
Nov. 28-Dec. 1, 1967
Exact locations will be announced later.
The workshop to be held in Quebec city will be conducted in the French language only.
English language nurses in the province of Quebec are invited to attend one of the work-
shops held in Ontario. French language nurses in New Brunswick are invited to attend the
workshop in Quebec city.
The workshops are open to directo
or assistant directors of nursing service in hospitals.
Registration is limited to 60 persons. The registration fee is $50.00. Because of the nature
of the workshop only full-time registrants can be accepted.
Here is an opportunity for directors and assistant directors of nursing service:
. to sharpen skills in problem-solving within a
"training laboratory" environment;
. to learn how problem-solving can be facilitated through group work;
. to stimulate orderly thinking toward the improvement of
nursing service;
. to identify the leadership role of the director of nursing service
and/or assistant director of nursing service in problem-solving and
decision making.
Interested! then plan now to attend the workshop in your area. Register early and avoid
disappointment.
I wish to register for the CNA Regional Workshop for Directors or
Assistant Directors of Nursing Service in Hospitals held in :
o Halifax 0 Regina
o Vancouver 0 London
o Toronto 0 Quebec City
Name
Title of Position
Years in Position
Name of Hospital
City or Town
Qualifications beyond RN
I enclose postal note (bank money order) for $
payable to the Canadian Nurses' Association.
Number of Beds
MAIL TO:
CANADIAN NURSES' ASSOCIATION
50 The Driveway
Ottawa 4, Ontario
10 THE CANADIAN NURSE
news
(Continued from paRe 8)
fits must be portable from province te
province, thus ensuring the national char-
acter of the plan. The amount of the
federal contribution will be based on the
average cost of insured services in particip.
ating provinces and will be calculated on
a per capita basis.
Canada's need for more trained health
personnel was recognized in July with the
passage of the Health Resources Fund
Act. It provides a fund of $500,OOO,OOC
over 15 years to assist in acquisition. con.
struction, renovation and equipping 01
health training facilities and research insti
tutions. The federal payments for an)
projects will be up to 50 percent of the
total cost. The balance need not, as ill
some federal-provincial programs, be
provided by the provincial government,
but may be supplied by any source designat-
ed by the province.
The Smoking and Health Program added
two major weapons to its arsenal - a
teacher's kit with completely Canadian
content and an animated film, The Drag.
The film, directed at teenagers, is bein
given theatrical screening across Canada.
A strong new link in the chain connecting
smoking and fatal diseases such as lung
cancer was forged by a recently published I
report of the department's Epidemiolog)
Division. It gives the results of a study
conducted from 1956 to 1962 on the mort-
ality rates of smokers compared to non-
smokers. Those surveyed were recipient
of pensions from the Department of Vete.
rans Affairs.
The new Canada Assistance Plan is a
federal-provincial measure designed to in-
tegrate existing public assistance programs
and to share for the first time the cost of
Mothers Allowances, health care, exten-
sions of welfare and administrative services.
and work activity projects. The program
places emphasis on the rehabilitation of
recipients to overcome and reduce depen-
dency on assistance and represents a signi-
ficant step in updating and rounding out
Canada's social security system.
It was a year of intensive activity for
the Canada Pension Plan. National head-
quarters in Ottawa and 37 district of-
fices across the country were established
and began processing the first applications
for retirement pensions. which started
January, 1967. Services provided to the
public by staff of these offices include:
receiving applications for benefits, assist-
ing in the completion of applications, coun-
seling, explaining pension computations
and furnishing other information on the
Plan.
(Continued 011 page 12)
FEBRUARY 1967
Making the Best Better
/".
,
I
""
"
'"
"
New 7th Edition!
TEXTBOOK OF ANATOMY
AND PHYSIOLOGY
Now in a new 7th edition, this highly successful text provides
the basic facts and principles of body structure and function
in a well-organized form. Student comprehension and interest
are increased through the two-color format and the superb
selection of illustrations, as well as the newly expanded full-
color Trans-Vision@ insert. This new edition gives thorough
coverage to the newer findings in all areas of anatomy and
physiology, omits the abundant detail which tends to confuse
students and places more emphasis on organizing facts about
explicitly stated principles. New learning aids include a list
of abbreviations widely used in physiology and a list of
common prefixes in scientific words. A new test manual is
provided without charge to all instructors who use this book
as the required text.
By CATHERINE PARKER ANTHONY, B.A., M.S., R.N. lIIustrat.d by ERNEST W.
BECK. Publication date: April, 1967. 7.... edition, approx. 570 pag.., 7" x 1a'.
About $8.40.
New 7th Edition!
ANATOMY AND PHYSIOLOGY
LABORATORY MANUAL
The new 7th edition of this popular laboratory manual
presents a streamlined method for recording results of experi-
ments and interpretations of those results, includes a greater
number of physiological experiments than previous editions,
suggests more audiovisual aids, includes chapter outlines and
self-tests. A time-saving answer book is provided without
charge to all instructors adopting this manual.
By CATHERINE PARKER ANTHONY, B.A., M.S., R.N. lIIustrat.d by ERNEST W.
BECK. Publication date: May, 1967, 7111 edition. About $4.00.
The C. V. MOSBY Company, ltd. Publishers
New editions of outstandingly successful
Mosby texts-improved and perfected
to meet your changing needs
New 4th Edition!
MEDICAL-SURGICAL NURSING
The most widely adopted text of its kind, now in a new
4th edition, this authoritative text continues to offer the
most practical, up-to-date integration of all information
required for the effective care and management of the
patient who is medically ill and/or undergoing surgical
treatment.
This new 4th edition has been improved and perfected,
providing you with a wealth of new material on patient
care. Now more than ever before, you can give your
students a thorough understanding of "total patient
care." All chapters and illustrations have been exten-
sively revised in the light of today's changing concepts
in health care and medical treatment.
Throughout this extensive revision two important con-
cepts in nursing care have been stressed: ( 1) the en-
larged concept of prevention-prevention of progression
or of complications of disease, and prevention of limita-
tions in living if handicaps do occur; and (2) the role
the patient's family plays in the patient's progress.
You will find instruction in the actual clinical situation
made easier through the inclusion of the principles of
anatomy, physiology and the social sciences as they
relate to care of sick people on each age level. Addi-
tional aids are the two-color format, assuring greater
readability, the study questions at the beginning of each
chapter, and a detailed bibliography. A 32-page Teach-
ing Guide is given to all instructors adopting this text.
By KATHLEEN NEWTON SHAFER, R.N., M.A.; JANET R. SAWYER, R.N.,
A.M.; AUDREY M. McCLUSKEY, R.N., M.A., Sc.M.Hyg.; and EDNA LlFGREN
BECK, R.N., M.A. Publication date: April, 1967. 4111 edition, apprax. 860
pag.., 7" x 10", 236 illustrations. About $10.80.
A New Book!
PRINCIPLES OF OBSTETRICS AND
GYNECOLOGY FOR NURSES
Utilizing a concise, fundamental approach to obstetrics
and gynecology, this new book can give YOUT students
an understanding of the foundations, theory and clinical
nursing practice as they concern fetal development, de-
livery, gynecologic complications and pathology. The
fundamental concepts and principles necessary for the
basics of nursing of the mother and child are clearly
defined.
By JOSEPHINE IORIO, R.N. Publication date: May, 1967. Apprax. 332
pag.., 6Y.' x 9%", 75 Illustrations. About $7.40.
.
86 Northline Road
. Toronto 16, Ontario
R
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NOTE: Order for 1, 2 or 3 penons on aboye
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"Oitterent" Ideas lor Gills and favors, Too!
12 THE CANADIAN NURSE
news
(Continued from page 10)
No.
169
Catholic Nurses Meet
The Association of Catholic Nurses of
Canada, in conjunction with the National
Council of Catholic Nurses of the United
States. will host the North American
regional congress. The congress will be
held in Montreal June 20 to 22, 1967 within
the framework of the Expo 67 theme. The
congress theme will be "Suffering of Man
and His World."
His Eminence, Cardinal Léger, Father
Tillard, O.P., and Dr. Eleanor C. Lamber-
tson, dean of the faculty of nursing at Co-
lumbia University in New York. will be
among the invited speakers.
The program will include seminars as well
as group meetings. An invitation to the
congress is extended to Catholic nurses all
over the world.
Barrie Students Raise Funds
for Overseas Student
"Our Chinese Girl" is the favorite ex-
pression among nursing students at the
Royal Victoria. Hospital in Barrie, Onl.
Since Miss Catherine M. Brown, director of
the Royal Victoria Regional School of Nurs-
ing, informed the students of a letter of
application from Miss Cecilia Chiu, a For-
mosan girl, the students have adopted a big
sister attitude toward her.
They have taken it upon themselves, as-
sisted by the Royal Victoria Hospital School
of Nursing, to raise money to assist Miss
Chiu with her entrance fees and expenses.
Miss Brown received Miss Chiu's letter of
application in July. Her academic standing
was acceptable by provincial standards, and
the young lady would have been accepted
for the first class of the new regional school.
However, the time-consuming factors of
mail delivery overseas and the trip to Barrie
would have made her arrive too late to
enter that class.
Miss Chiu, having been informed that the
school entrance fee was $200, and knowing
that she would need money to live on while
in Canada, believed that she would need
another $500. She mentioned in her letters
that she had enough money saved for her
passage to Toronto, and that she would
keep her secretarial position in Formosa
during this year, but she would still likely
need financial help.
It was at this point that the studen"
began their money-raising campaign. The
students have a permanent baby-sitting pro-
gram whereby one-half the money goes to
the fund. They also have held a benefit
dance, a hay ride, a hockey raffle and a
hockey pool. Through the generosity of a
local service ..tat ion operator. the ..tudenls
held a gas-o-rama at which they received
a commission on every gallon of gas they
pumped. They have also received several
offers of help and several donations from
individuals in the area.
To date, they have raised $336, with a
goal of $500-$600. They are still looking
for imaginative ways to raise the resl.
When asked why they were doing this for
a girl they had never seen, Miss Mary
Ellen Empringham, chairman of the fund-
raising committee replied: "Because she has
made such an earnest effort to manage her
passage here. we do not feel she should be
deprived of her wish. We also believe that
nurses are to help people and, even though
we are far from being nurses, we believe thi..
campaign, its challenge, and the accomplish-
ment of our goal will furnish a test of our
qualities and characters as future nurse.....
New Method for
Early Cancer Detection
Investigations that began JO years
ago at the Royal Victoria Hospital in
Montreal are leading researchers to believe
that "heat pictures" or thermograms of
the thorax could be the best method of
detecting breast cancers, the commonest
tumors in women.
Detection of breast cancer at a very early
stage is not usually possible by ordinary
techniques. However, since at least 90 per-
cent of patients with breast cancer show ab-
normal temperature variations of 10C or
more in the breast skin over the lesion,
doctors feel that this sign should be ex-
ploited as for as possible. There is also
evidence that the degree of malignancy is
related to the degree of temperature eleva-
tion.
Now, a Canadian breast surgeon, Ray
N. Lawson, has developed a method of
producing heat pictures of the thorax that
clearly portrays these temperature varia-
tions. Dr. Lawson uses infra-red radiation
devices plus a scanning or image-producing
device that gives a two-dimensional map
or thermogram. The device is similar to
the radar screens used on ships or in air-
plane towers, except that it is sensitive to
heat variations.
Investigations are currently underway to
engineer improved electronic gear for
displaying temperature patterns. "At pre-
sent, military needs have a much higher
priority than those of medical research,"
says Dr. Lawson. "Knowledge of certain
new advances in thermal physics that would
help advance our techniques is presently
unavailable to medical researchers."
Engineering research in thermdl physics
is also particularly costly. Since Novem-
ber, 1966, however, the American Cancer
Society has been sponsoring a program to
evaluate the use of thermography diagnosis
in breast cancer, and some enthusiastic
reports have already been given.
FEBRUARY 1967
news
Using new techniques, scanning of large
body surfaces takes less than a minute and
permanent records of the area can be
available for study 10 seconds after the
scan.
The new scanning techniques would also
be applicable in other medical areas, such
as placenta location in obstetrics, arthritic
disease, dennatology and arteriosclerosis.
It is now established in some clinics as a
most useful aid in cancer detection, evalua-
tion of benign conditions. and follow-up
surveys searching for cancer spread.
Toronto's Street Haven
Started by RN
Street Haven, a refuge in Toronto for
prostitutes, drug addicts, alcoholics, and
lesbians, owes its existence to a thirty-year
old registered nurse who has a big heart
and a faith in human nature to match.
Peggy Ann Walpole, a graduate of St.
Michael's Hospital School of Nursing in
Toronto, and now executive director of
Street Haven, started this refuge for female
offenders in March, 1965. At that time
the Haven consisted of one room - an
unused beverage room in an old hotel -
and had no official financial backing.
Today, as a non-sectarian organization
that uses the services of more than 50
volunteer workers, the Haven occupies
2,000 square feet above a store in down-
town Toronto and contains bright, airy
living rooms, an office, and a large kitchen.
A monthly budget of $2,100 is made up of
grants from the Alcoholism and Drug Ad-
diction Research Foundation, Eaton's, priv-
ate donors, and the United Church of
Canada.
The idea of establishing a refuge for
Women who are "at the bottom of the lad-
der" came to Miss Walpole after she had
read The Junkie Priest, by Father Daniel
Egan, founder of a similar haven in New
York. Before reading this book, she had
become convinced that something other
than the usual halfway house was needed
for women who had been caught in the
web of narcotic addiction, prostitution,
and petty crime.
"No woman is an addict or a prostitute
by nature," says Miss Walpole, who en-
countered many such persons as a nurse
at St. Michael's, at a halfway house in
Toronto, and at the city's Don Jail. "Usual-
ly she is pressured into the life. All too
often she is released from prison without
money, without worthwhile friends, with-
out a job, and with no place to go. When
she returns to crime, it is for survivaL"
The average age of the girls at the Haven
is 23. Some come voluntarily for assistance,
others are escorted by the police, or are
FEBRUARY 1967
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Miss Peggy Ann Walpole, R.N., founder and executive director of Street Haven.
a Toronto refuge for female offenders, chats with luncheon visitors in the
Haven's public tearoom. Eaton's of Canada helped furnish this room.
referred by the courts. Recently, two young
girls were brought to the Haven by an old
prostitute from a brothel where the girls
had been living.
At the Haven. the girls are accepted and
given individual attention by Miss Walpole
and her volunteers. The informal therapy
consists of discussion groups, including
Sunday evening sessions with young men
from a Youth Anonymous group from
Hamilton; recreational activities. such as
bridge, ping-pong, darts, and a weekly
hootenanny; instruction in the techniques
of serving and cooking for Street Haven's
tearoom, which is open to the public; and
arts and crafts. Some girls are directed to
adult retraining centers for clerical courses;
others are assigned small housekeeping
responsibilities in the Haven.
The volunteers, all of whom are inex-
perienced when they come to Street Haven,
involve themselves in all aspects of work.
They write to and visit girls who are in
hospital and jail; arrange to meet them on
discharge from jail; pick up donations of
furniture and clothing; assist with secre-
tarial work; go on emergency calls to hos-
pitals, and often to the "corners"; and
attend court sessions.
Nurses interested in volunteer work at
the Haven should write: Street Haven, 2
Teraulay Street, Toronto, Ontario.
B.G.H. Receives
Building Grant
The Belleville General Hospital has been
awarded a federal grant of $995,900 for
construction and renovation programs.
The hospital will add a new wing to its
present building to provide space for 293
active treatment beds and 44 beds for the
care of psychiatric patients. The wing will
also contain new operating rooms, x-ray
department. laboratories and other facilities.
Renovations to be carried out In the
existing north wing will provide for an
86-bed chronic care unit. Other renovations
will include improvements to nurses' sta-
tions. the enlargement of the physiotherapy
department. modernization of the laundry,
and additional space for the kitchen.
Work is already underway and is schedul-
ed for completion about November, 1967.
New Services at
L'lnstitut Albert Prévost
Since the beginning of December. I1nstitut
Albert Prévost in Montreal has offered the
Quebec population three new psychiatric
services: a diagnostic center. a day-care
center. and a center for disturbed adoles-
cents. This new undertaking aims to permit
easier access by the public to specialized psy-
chiatric services.
The diagnostic center permits centraliza-
tion of all applications for care. Immediate
consultation is available for patients who
come to the center and appointments will
be made within 24 hours for those who tele-
phone. After a preliminary evaluation,
patients can be directed to the appropriate
services. The outpatient clinic will now be
limited to treatment of ambulatory patients.
The day-care center can accomodate 20
persons. These come to the hospital several
days each week from 9:00 A.M. to 4.00
P. M. These patients are those who. follow-
ing hospitalization. require a period of
adaptation to life outside the institution.
those who need medical supervision, or those
who do not need continuous hospital treat-
ment but who will benefit from institutional
services on a day basis. Experiments in other
centers have shown that hospitalization can
be reduced and often avoided. Therapeutic
techniques center around group therapy and
activities.
(Continued on page 14)
THE CANADIAN NURSE 13
Gynecologist's Claim Investigated
An American gynecologist is being in-
vestigated by the U.S. Food and Drug
Administration, according to Canadian
Doctor, for claiming that oral contracep-
tives prevent menopause.
Dr. Robert A. Wilson, of Brooklyn,
New York, made the claim in his recently
published book Feminine Forever.
FDA spokesmen said the statement is
being investigated to determine whether it
extends beyond claims made for the con-
traceptives on labeling approved by the
Administration.
An advisory committee which recently
news
(Continued from page 13)
The center for dislUrbed adolescents pro-
vides beds for 10 patients and is reserved
for boys from 14 to 18 years. This service
brings to 160 the number of beds for
adolescents of both sexes in the Montreal
region. The center is attached to the child
psychiatry division.
The outpatient clinic and the day-care
center will eventually include adolescents of
both sexes.
ONE-STEP PREP
"
with
FLEET ENEM
sÙzgle dose
disposable unit
FLEET ENEMA's Fast prep time obsoletes soap and
water procedures. The enema does not require warm-
ing. It can be used at room temperature. It avoids the
ordeal of injecting large quantities of fluid into the
bowel, and the possibility of water intoxication.
The patient should preFerably be lying on the leFt side
with the knees flexed, or in the knee-chest position.
Once the protective cap has been removed, and the
prelubricated anatomically correct rectal tube gently
inserted, simple manual pressure on the container
does the rest! Care should be taken to ensure that
the contents of the bowel are completely expelled. LeFt
DIo.I.,&
colon catharsis is normally achieved in two to five
minutes, with little or no mucosal irritation, pain or
spasm. IF a patient is dehydrated or debilitated,
hypertonic solutions such as FLEET ENEMA, must
be administered with caution. Repeated use at short
intervals is to be avoided. Do not administer to children
under six months of age unless directed by a physician.
And afterwards, no scrubbing, no sterilisation, no
preparation For re-use. The complete FLEET ENEMA
unit is simply discarded!
Every special plastic "squeeze-bottle" contains 4'h
fl. oz. of precisely Formulated solution, so that the
adult dose of 4 fl. oz. can be easily expelled. A patented
diaphragm prevents leakage and reverse flow, as well
as ensuring a comFortable rate of administration.
Each J 00 cc. of FLEET ENEMA confains:
Sodium biphosphate _ _ . 16 gm.
Sodium phosphate . . . . . . . . . . .. 6 gm.
For our brochure: "The Enema: Indicatians and Techniques",
containing full information, write to: Professional Service
Department, Charles E. Frosst & Co., P.O. Bax 247,
Montreal 3, P.Q.
j
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A QUALITY PHARMACEUTICALS
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14 THE CANADIAN NURSE
completed a nice-month study of contra-
ceptives reported no data indicating that
any of the oral type are effective in altering
the natural history of patients.
An assistant to the FDA Commissioner
said the issue is "a very involved legal
question."
Metabolic Research Ward
Opens in Winnipeg
Winnipeg Children's Hospital, Manitoba,
opened a new ward for the diagnosis and
treatment of metabolic disorders in children
in mid-January, 1967.
By coordinating the efforts of medica]
and parameòical personnel, dietitians, bio-
chemists, pharmacists, nurses, occupationaJ
therapists, and social services, the metabolic
ward will provide a complete range of
services for both diagnosis and treatment of
these disorders. I
The unit will also offer services on an I
outpatient basis, and conduct educational
programs in the home management of meta-
bolic disorders.
The diagnosis of metabolic disorders is
often delicate and painstaking and requires
the young patients to undergo series of
tests including careful measurement of die- I
tary intake and excretions. Apparatus for
collecting specimens from young children I
plus storage facilities for these specimens I
will be standard equipment in the new ward.
Of the more than 100 metabolic disorden
that have been diagnosed, some are tem.
porary while others require a lifetime 01
treatment. By opening its new ward, the
Winnipeg Children's Hospital is joining the
fight to lower the dea.th rate among childrel1 I
suffering from such diseases.
Mrs. Manfred Jager, appointed head
nurse on the ward, prepared for her ne'" I
position by inspecting metabolic wards ill
Toronto, Boston, and Montreal. Mrs. Jager
a graduate of the Winnipeg Children's Hos-
pital, worked there as staff nurse and assis.
tant evening supervisor, and assisted in esta-
blishing a day hospital for children at the
Mount Carmel Clinic in Winnipeg.
The ward, to be located in the "four south
section of the hospital," will be specially
equipped with both the personnel and appa-
ratus necessary to diagnose the disorders.
No Gyn on Obs!
New Jersey has stopped hospitals in that
state from combining the care óf obstetric
and gyneologic patients on the same nursing
unit, according to an item in RN.
The December issue of the nursing
magazine reported that a three-year pilot
study had been stopped by the state be-
cause the hospitals involved in the research
often violated the s!rict rules governing
the admission of gyneologic patients to
the maternity floors. "If pilot hospitals
under close check ignore such criteria,
other hospitals are even more likely to do
so," said one state official.
(Continued on page 16)
FEBRUARY 1967
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GO!... Where the ACTION is!
.
· Mrs. Helen Middleworth, Director, Nursing Service
· Albany Medical Center Hospital
.
. Albany, New York 12208
Albany Medical Center, that's where. A modern teaching hos- .
pital perfectly located in beautiful upstate New York . . . on .
the doorstep of New York City's bright lights . . . exciting .
horse racing at Saratoga. . . summer homes of the Philadelphia ·
and Boston Symphony Orchestras. . . scenic lake George . .. ·
.
and the greatest skiing in the East. .
Our nursing opportunities are tops, too. For details, send for ·
our free booklet, "Albany Medical Center Nurse." ·
.
.
Albany Medical Center Hospital :
Please send me a free copy of your nursing booklet.
NAME ................. ...... ...... .,___. ......
ADDRESS _. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:E8RUARY 1967
CITY ...............STATE ...........ZIP......
THE CANADIAN NURSE 15
MOVING
?
.
DON'T FORGET YOUR
CHANGE OF ADDRESS
Name:
Registration No.:
(If registered in two provinces,
please give both.)
Province:
Old Address:
New Address:
Date effective:
Allow at least six weeks
for change of address
Mail to:
The Canadian Nurse
50 the Driveway
Ottawa 4, Onto
16 THE CANADIAN NURSE
news
(Corzt;ll11ed from page /4)
"Operation Hospital Supplies"
Health Minister M. B. Dymond has an-
nounced plans for Ontario's Department of
Health to provide equipment for West Indies
hospitals. The project will be known as
"Operation Hospi
al Supplies."
Dr. Dymond revealed that several weeks
ago his Department had initiated a survey
throughout general and psychiatric hos-
pitals in Ontario to ascertain what surplus
equipment is on hand for disposal. Corres-
pondence with the Ministers of Health of the
West Indies had previously revealed that
most of the island hospitals lack many
pieces of equipment that Canadians asso-
ciate with a well-run hospital.
"Early survey returns received from a
few hospitals here in Ontario have been
more than gratifying," stated Dr. Dymond.
"I am confident Operation Hospital Supplies
wi1l prove to be a highly successful project
and most helpful to the people of the Carib-
bean. I feel aU Canadians can share a
sense of pride in the knowledge that a
Centennial project of this nature will add
to the health and well-being of their less
fortunate Commonwealth partners," he ad-
ded.
Equipment such as beds, bedpans, tables,
trays, kidney basins is being requested. All
Ontario hospitals, including their medical
and nursing staffs have been invited to sup-
port Operation Hospital Supplies throughout
1967.
RNAO Recommends Change
In Public Health Act
An amendment to Ontario's Public
Health Act was one of the recommenda-
tions submitted by the Registered Nurses'
Association of Ontario to the provincial
government's Committee on the Healing
Arts last December.
RNAO recommended "that the Public
Health Act be amended to ensure that
nursing service prQvided by public health
nurses be an integral part of any public
health unit." The present Act allows a
public health unit to function with the
provision of nursing services to the com-
munity. This, in effect, means that the
community is not guaranteed the services
of public health nurses.
In addition to denying the community
of nursing services, this omission in the
Act has another ramification, according
to the RNAO brief. "There are implica-
tions for public health nurses who might
wish to become involved in negotiating
with their employer, as it is quite within
his rights to discontinue public health nur-
sing services without closing down the
unit."
ICN Council of International
Representatives to Meet in July
The Board of Directors of the Interna-
tional Council of Nurses discussed the
tentative agenda for the meeting of the
Council of National Representatives to be
held June 26 to July 1, 1967 at Evian,
France. The agenda includes suggested
plans for the next ICN Quadrennial Con-
gress to be held in Montreal in July, 1969.
The executive director and the president
of the Canadian Nurses' Association will
attend on behalf of Canada. The other 63
member countries are expected to send
representatives also.
At this meeting the theme for the 1969
Congress will be chosen. Seventeen national
member associations, including Canada, have
submitted suggested themes. The subjects
reflect the wide concern of the associations
for the adaptation of nursing to the tech-
nological age and their interest in nursing
research and nursing administration.
Pharmaceutical Firm Expands
Construction of a new wing is well under
way at The British Drug Houses (Canada)
Ltd., and the building is scheduled for
completion in early 1967. Twelve thousand
square feet on two floors are being added
to the existing plant in surburban Toronto,
at a cost of $750,000.
The increased laboratory facilities will
enable BDH to play an even greater part in
research and development of medical pro-
ducts, laboratory chemicals and general
chemicals, according to Mr. F. Burke.
managing director of the company.
Winners Fly to
Easter Island
A jet trip to Easter Island is in the im- I
mediate future for Mr. and Mrs. G.H' I
Pimm of 251 Park Road, Rockcliffe, Ot-
tawa. Mr. Pimm is the winner of the Easter
Island contest mentioned in the August
1965 issue of THE CANADIAN NURSE.
Purpose of the contest was to raise mone)
to pay for trailers left on Easter Island b)
the Canadian Medical Expedition.
In an article "Aku-Aku And Medicine
Men" (August 1965), Carlotta Hacker.
staff member of the expedition, explained
how the trailers were left. During a two-
month medical survey conducted on the
island by Dr. Skoryna, the 37 team mem-
bers lived and worked in ACTA trailers
which they donated to the Pascuenses on
their departure "as a much-needed annex
to the hospital and as a permanent biologi-
cal station."
Following the article, a contest was an-
nounced to help pay for the trailers. B)
becoming an Associate of the Easter Island
Expedition Society at the cost of $1.00,
one became eligible for a free trip to
Easter Island.
Mr. Pimm and his wife, winners of the
contest, will fly to the Island via Chile, by
Canadian Pacific Airways.
FEBRUARY 1967
I
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FEBRUARY 1967
o
'I
I
ç
When the
call is for IIStat."
diagnostic findings
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results in which you can have the utmost
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blood. The new firm, clear, plastic reagent strip permits
precise, reproducible readings in all 5 diagnostic areas.
DEXTROSTIX. Reagent Strips: provide a blood glucose
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CliNITEST. Reagent Tablets-provide a quick, reliable,
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AMES tests are easy to perform and require no elaborate
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of colour changes observed after testing, with colour charts
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THE CANADIAN NURSE 17
names
o n J a n u a r y 2,
1967, Tatiana La be-
koYSki wilJ take up
her duties as the first
director of the new
Cornwall Regional
School of Nursing.
Although the class-
rooms and residence
of the new school
are not yet under construction, Mrs. Labe-
kovski's appointment will mean "the begin-
ning of a concentrated effort to get things
ready for the new class," for September,
1967.
Mrs. Labekovski received her B.A. in
philosophy and philology from the Uni-
versity of Belgrade, Yugoslavia, and con-
tinued on toward a medical degree until her
studies were interrupted by World War H.
After her arrival in Canada, she grad-
uated from St. Joseph's School of Nursing
at Hotel Dieu Hospital, Cornwall, obtained
her diploma in nursing education from
Queen's University, and was a member
of the teaching faculty at the Cornwall
school of nursing for six years.
In the past four years, Mrs. Labekovski
has been assistant secretary, nursing edu-
ootion and service at the Toronto head of-
fice of the Registered Nurses' Association
of Ontario.
Mrs. Labekovski arrived in Cornwall
late this December to "settle in before
starting to work on her rather monumental
task."
All inquiries about the new school should
be directed to the schools of nursing at
either of the local hospitals. They will be
collected and held there until Mrs. Labe-
kovski has set up her office procedures.
At the end of November 1966, the
Canadian Nurses' Association in Ottawa
welcomed two interesting visitors - Miriam
M. Hornsby-Odoi and Ah Foo Chong -
both on World Health Organization fellow-
ships.
Mrs. Hornsby-Odoi, a native of Ghana,
was awarded a six-month fellowship com-
mencing November 14, 1966, to study
public health nursing administration in
Canada and the United States.
Since 1963 she has been principal public
health nurse with the ministry of health
in Accra, Ghana.
Following her study, Mrs. Hornsby-Odoi
plans to introduce and apply new practical
ideas to improve the organization of public
18 THE CANADIAN NURSE
health nursing service in Ghana.
Miss Ah Foo Chong, whose six-month
award began January 3, 1967, is studying
public health nursing administration at the
University of California and in San Fran-
cisco, Minnesota, New York, Washington,
Baltimore, and Canada.
Since 1963 Miss Ah Foo Chong has
served with the Ministry of Health, Kuala
Lumpur, Malaya as principal matron. In
this position she has administrative duties
at national level and is responsible to the
director of medical services for the develop-
ment and expansion of the health and
medical nursing service and nursing train-
ing programs.
The fellowship wilJ provide "an op-
portunity to work with nurses who are res-
ponsible for the administration of public
health nursing programs at the national,
state, and local levels in the U.S. and Ca-
nada." On her return home, Miss Ah Foo
Chong wilJ be in a position to apply "new
ideas in the development of these services,
and to analyze the existing public health
nursing services."
-,
- ..
Ramona Paplaul-
kal-Ramunal, a na-
tive of Lithuania, has
recently joined the
editorial staff of
L'INFIRMIÈRE CANA-
DlENNE.
Miss Paplauslcas-
Ramunas attended the
University of Ottawa
where she obtained her B.A. and B.Sc. in
1961. After graduation, she gained five
years' experience as a publications editor
with the Canadian Department of Agri-
culture.
A member of various organizations, Miss
Paplauskas-Ramunas has also held executive
positions with the Ottawa Citizenship Coun-
cil, Canadian Industrial Editors' Associa-
tion, and the Professional Institute of the
Public Service of Canada.
Recently appointed
to the newly esta-
blished position of
nursing advisor in
public health psy-
chiatry for The On-
tario Hospital, King-
ston, was Helen Eliza-
beth Etherington.
A graduate of the
I", .
"i!
':;
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1(iL
...
Mack Training School, St. Catharines,
Ontario, Miss Etherington has also received
postgraduate education in both public health
nursing and administration and supervision
in public health nursing from the Univer-
sity of Toronto. In 1963-64 she attended
the McGilJ School for Graduate Nurses
where she obtained a diploma in teaching
and supervision in public health nursing
with a major in psychiatric nursing.
Her experience has included two years
as a faculty member at The Ontario Hos-
pital School of Nursing, Kingston, and
seven years in various public health nursing
positions including that of supervisor of
public health nursing with the department
of health, Peterborough.
Helen Jean Hanel,
a 1953 graduate of the
school of nursing at
the Calgary General
Hospital, recently as-
sumed her new posi-
tion as director of
nursing at the Nanai-
mo Regional General
Hospital, Nanaimo,
British Columbia.
Prior to her new appointment, Mrs.
Hanel worked at the Royal Inland Hospital,
in Kamloops, B.C. as associate director of
nursing services. Other experience includes
two and one-half years as director of nur-
sing at the Union Hospital, Canora, Sas-
katchewan, and service as a general duty
nurse in St. Paul's Hospital, Saskatoon,
and the Union Hospital, Swift Current,
Saskatchewan.
Ena Maud Orr,
director of nursing
of the Ontario Hos-
pital, Brockville, On-
tario, for the past 35
years, retired Decem-
ber 31, 1966.
Mrs. Orr graduat-
ed from the Ontario
Hospital School of
Nursing, Toronto. In 1930 she was among
the second class to graduate in nursing
education from the University of Toronto.
Before assuming her duties as director
of nursing in Brockville, she was an in-
structor at the Ontario Hospital, Toronto.
Almost 400 nurses have graduated from
the school of nursing "which she shaped
and kept vigorous through the many
changes in nursing education."
n
.
FEBRUARY 1967
Barabara Ellemer.
has been appointed
assistant superinten-
dent of nursing educ-
ation for the Saskat-
chewan Department
of Education.
A 1958 graduate
of the school of nur-
sing of the Regina
:Jeneral Hospital, Mrs. Ellemers also ob-
ained a diploma in public health nursing
'rom the University of Saskatchewan, a
B.N. from McGill, and is presently work-
ng toward her M.A. at the University of
)askatchewan.
.
Prior to her present appointment, Mrs.
Ellemers served with the Victorian Order
Jf Nurses, the Saskatchewan Department
Jf Public Health, and the Regina City
Health Department. She also worked at
the Jewish General Hospital in Montreal
in 1962-63 as an instructor and during the
following year as a lecturer at the McGill
University School for Graduate Nurses.
Valerie O'Connor, former editor of the
International Nursing Review, recently be-
came the new editor of Hospital World.
Miss O'Connor, awarded the Gilchrist
Scholarship to study in Great Britain in
1961, was the first Australian nurse to
undertake an academic course in journalism.
On completion of her studies at the Regent
Street Polytechnic School of Journalism,
she joined the editorial staff of Nursing
Mirror. Subsequently she went to the Inter-
national Council of Nurses as public rela-
tions officer and editor of the Council's
publication.
Lelia Raymond of the United Kingdom,
has been appointed acting editor of the
International Nursing Review. Until recent-
ly, Miss Raymond was clinical instructor
at King's College Hospital, London, Eng-
land.
She undertook her basic nursing educa-
tion at King's College Hospital; her post-
basic nursing education includes a certifi-
cate for clinical instructor and teacher.
She has been joint editor of the King's
College Hospital Nurses League Journal,
which appears annually.
W.S. Hacon, former chief of the Emergen-
cy Health Services Division for the Depart-
ment of National Health and Welfare, reli-
quinshed his appointment recently to accept
a new position with the department.
Mr. Hacon is the new director of Health
Resources in the Department of National
Health and Welfare.
His successor in the Emergency Health
Services has yet to be appointed.
FEBRUARY 1967
Georg Feilotter, for-
mer instructor at the
Cornwall General
Hospital School of
Nursing, is the newly
appointed assistant di-
rector of nursing (ser-
vice) at the hospital.
I
Mr. Feilotter gra-
duated as a nurse in 1954 in his native
Gennany, and emigrated to Canada in
1960. His first Canadian appointment was
at the Victoria General Hospital in Win-
nipeg where he worked in medical-surgical
nursing. From 1962 to 1964 he was a head
nurse at the newly built Rehabilitation
Centre in Winnipeg.
Mr. Feilotter next attended the Univer-
sity of Ottawa where he obtained two
diplomas, one in rehabilitation nursing and
the other in teaching and administration.
He is presently doing part-time study lead-
ing to his B.Sc.N.
Mildred Irene Walker. who retired Novem-
ber 30, 1966 as senior nursing consultant in
the occupational health division of the
Department of National Health and Welfare
(THE CANADIAN NURSE, January, 1967) died
in hospital on January 16.
Miss Walker began her nursing career in
1924 with her graduation from the Victoria
Hospital School of Nursing, London, On-
tario. Her busy career was largely adminis-
trative and included experience as a lecturer,
assistant professor, and public health nurse.
Miss Walker became senior nursing consul-
tant in 1949, a position she maintained until
her retirement last November.
"A gifted Ontario woman," and a great
Canadian nurse, Edith MacPherson Dickson,
died recently after a long and active life.
The number of highlights in her profes-
sional career indicate the major role she
played on the Canadian nursing scene.
After graduating from the Toronto Gen-
eral Hospital School of Nursing, where she
was noted "as being a leader" by Mary
Agnes Snively, founder of the Canadian
Nurses' Association, Miss Dickson went to
Weston as superintendent of nurses for the
Toronto Tuberculosis Hospital.
During the fonnative years of 1920-22
Miss Dickson served a tenn as president of
CNA. She was also the driving force that
led to the passing of the Ontario Registration
Act.
One of the first three recipients of the
Mary Agnes Snively Medal for outstanding
accomplishments in nursing in Canada, Miss
Dickson was also awarded an honorary life
membership in CNA in 1958.
Her many activities included membership
on the committee to erect a national memo-
rial in the Hall of Fame, Parliament Build-
ings, Ottawa, in honor of nurses who lost
their lives in the First World War.
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Try the Mt. Sinai Hos-
pital of Cleveland which
offers $500 a month be-
ginning salaries, educa-
tional opportunities, and
job satisfaction - all in
the cultural center 'of the
city. Write to Nurse Re-
cruiter, Dept. CA for more
information.
THE MOUNT SINAI
HOSPITAL OF CLEVELAND
Uninrsiry Cirde . Clevellnd, O.io 4-4106
THE CANADIAN NURSE 19
Save hours of your time D 1 1 @
by replacing the enema with... U CO ax Suppositories
,
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,
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...
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J
Even modern enema equipment is cumbersome and time-.
consuming to assemble. Irrigation poles, bags, tubing,
bedpans-all must be drawn from Central Supply, in-
spected and brought to the bedside. It cuts into your valu-
able morning time and becomes a real burden when you
have several patients needing enemas.
And, more often than not, your patients are distressed at
the prospect of discomfort and loss of dignity-especially
the elderly, the seriously ill, or postpartum and post-
surgical patients.
Dulcolax (brand of bisacodyl)
Dulcolax Suppositories 10 mg
Dulcolax Suppositories for Children 5 mg
Dulcolax Tablets 5 mg
"
Dulcolax Suppositories offer a sure, simple way to elimi-
nate the enema routine. One small suppository is inserted
in seconds. You like the simplicity and convenience-
patients are grateful to be spared the ordeal of an enema.
Dulcolax Suppositories usually act in 15 minutes to I hour,
so you can time evacuations and reduce accidents. You
can finish the whole ward in less time, with Jess effort,
less soiled linen.
Boehringer Ingelheim Products
Division of Geigy (Canada) Limited, Montreal
8-S 113-6S
dates
February 9-10, 1967
Meeting of Standing Committee on
Nursing Education, CNA House,
Ottowa.
End of March
Institutes for Instructors
Ramada Inn, Vancouver, B.C.
A two-day institute sponsored by the
Registered Nurses' Association of B.C.
March 19 and 22, 1967
Deportment of Notional Health and
Welfare, Notional maternal and
Child health conference.
Talisman M.otor Hotel, Ottowa.
Inquiries: Dr. Jean Webb, Chief.
Child and Maternal Health Division,
Deportment of Notional Health and
Welfare. Brooke Claxton Building,
Ottowa 3, Ontario.
April 28, 1967
Nurses' institute on respiratory
disease, Notional Museum, Otta
a.
For information write The Canadian
Tuberculosis Association, 343
O'Connor Street, Ottowa 4.
May 4-6, 1967
St. Boniface Hospital, School of
Nursing, 25th Reunion of the 1942
graduating closs.
Would members of the 1942
graduating closs please write to Miss
F.E. Taylor. R.N., 10123-122 Street.
Edmonton.
May 8-12, 1967
Notional League for Nursing, Biennial
Convention. Theme: "Nursing in the
Health Revolution."
New York Hilton Hotel, New York City.
May 10-12, 1967
Canadian Hospital Association,
Montreal. P.Q.
May 15, 1967
Notional Nursing Day.
May 16-19, 1967
Alberto Association of Registered
Nurses Annual Meeting.
Chateau Lac:>>mbe, Edmonton, Alberto.
May 24-26, 1967
International symposium on electrical
activity of the heart.
London. Ontario.
For further information, write to
Dr. G.W. Manning, Victoria Hospital,
London. Onto
FEBRUARY 1967
May 29-31, 1967
Operating Room Nurses' Fourth
Ontario conference.
The Inn on the Pork, Toronto, Ontario.
Sponsored by the Operating Room
Nurses of Greater Toronto.
Direct inquiries to: Mrs. Eleanor
Conlin, R.N., 437 Glen Pork Avenue.
Apt. 309. Toronto 19. Ontario.
May 31-June 2, 1967
Registered Nurses' Association of
Novo Scotia Annual Meeting. Sydney.
N.S.
May 31-June 2, 1967
Registered Nurses' Association of
British Columbia Annual Meeting
Bayshore Inn, Vancouver, B.C.
June 5-8, 1967
Atlantic Provinces Hospital Association,
Annual Meeting.
June 12-15, 1967
Canadian Dietetic Association 32nd
Convention
Chateau Laurier, Ottowa.
June 18-21, 1967
Ottowa Civic Hospital, Centennial
Home Coming.
Alumnae of former associates of the
Ottowa Civic Hospital who are
interested in the program should
write to: Executive Director, Ottowa
Civic Hospital.
June 18-23, 1967
Canadian Medical Association,
100th annual meeting, M.ontreal,
Quebec.
Address enquiries to Dr. A.D. Kelly,
Executive Secretory. 150 St. George
St., Toronto 5, Ontario.
June 24, 1967
St. Joseph's Hospital School of
Nursing, Toronto, Centennial Reunion.
Any graduates who do not receive
alumnae newsletters. please send
nome and address to: St. Joseph's
Hospital School of Nursing Alumnae.
30 The Queensway, Toronto 3,
Ontario.
July, 1967
75th Anniversary, Novo Scotia
Hospital School of Nursing.
Dartmouth. N.S.
All interested graduates please
contact Mrs. G. Varheff,
20 Ellenvale Ave.,
Dartmouth, N.S.
NEW FOR HOSPITALS
the
Autolope
It responds
to heat
treatment.
....
".,......,.,...
""
.'
......-
.. .,."",
. :/;
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........
When the contents of the enve-
lope are completely sterilized by
the Autoclave, the indicator ink
changes colour. This unique Gage
Autolope is security folded and
pressure-sensitive gummed to
prevent contamination. It was de-
veloped for AutocIaving w
th .the
help of medical, paper, pnntmg,
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The Aut
lope is available now in
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THE CANADIAN NURSE 21
A nursing career with a difference.
Excellent career opportunities exist
for graduate nurses in the Canadian
Forces Medical Service. Applica-
tions will also be accepted from
nursing s tuden ts in their final
year of training. And enrolment
will proceed upon registration.
The duties of a Canadian Forces
Nursing Sister are two-fold; that of
a professional nurse and that of a
commissioned officer. Her employ-
ment therefore .. J carries with it
the respon-
'sibilities of
leadership as .
well as those
of the medical \ '1 profession.
It also carries with it op-
P 0 r tun i tie s l' to travel, to
serve in Canadian
l military es-
tablishments all across Canada
and in Europe.
The starting salary is $540.00 a
mon th, and increases in pay are
granted every three years. 30 days
annual holiday, and free medical
and dental care are added benefits.
Nursing in the Canadian Forces
Medical Service offers valuable and
varied experience in different en-
vironments, opportunities for pro-
fessional advancement, the excite-
ment of travel at home and over-
seas, a respected position, and a
unique way of life not usually
available to a Registered Nurse.
Further information and appli-
cations for enrolment may be ob-
tained from your nearest Canadian
Forces Recruiting Centre, or by
mailing the attached coupon.
The Canadian Forces.
Give it some thought.
r-----------------------,
Director of Recruiting,
Canadian Forces Headquarters,
Ottawa 4, Ontario
Nam ..
Addres "
City or Town, and Provinc ..
L_______________________
22 THE CANADIAN NURSE
FEBRUARY 1967
in a capsule
Drugs from the Depths 1
The underwater life of Australia's Great
Barrier Reef may be a potential source of
new therapeutic agents, according to Dr.
Robert Endean of the University of Queens-
land.
Working with a six-man team, Dr. Endean
has isolated from one variety of cone shell
a toxin that produces muscular relaxation.
This toxin affects only skeletal muscles, and
does not appear to produce any of the side
effects associated with curare type of drugs.
Another variety of cone shell has yielded
a toxin that cause
sustained contraction
of muscle. Dr. Endean reports, "I know
of no other substance in the world which
can achieve this effect, and it may prove
to be valuable as a heart stimulant. We
have already successfully tried it on the
heart muscle of the toad." - The Horner
Newsletter.
"Pure" Doctors
A selection of nurses' examination mis-
takes, compiled by Roger Brook, has been
published by the Souvenir Press, London,
under the title "And after that Nurse?" The
following excerpts show just how important
wording can be. . .
A cross infection committee was set up
in the hospital to deal with affection be-
tween nurses and patients.
Phenobarbitone. may be given to seduce
the patient and put his mind at rest.
Cross infection is always blamed on
nurses, but the real bugbears in this respect
are the doctors who think they are too
pure to carry such things as germs. -
Nursing Mirror, 122: 599, Sept. 23, 1966.
The Nose Knows
One of the most disagreeable factors in
working with geriatric patients, particularly
those who are incontinent, is urinary odor
which frequently permeates the entire en-
vironment where patients are housed. A
report in a medical journal stating that
cranberry juice was used to deodorize
wards having incontinent patients, prompted
Charles R. Du Gan and Paul. S. Carda-
ciotto to conduct an experiment in two
geriatric wards, one containing 110 male,
the other 110 female patients.
During the program the usual methods of
deodorization were discontinued and odor
levels were obtained chemically as well as
noted subjectively by personnel.
The doses of cranberry juice were gra-
dually increased from three ounces per pa-
tient per day to a maximum of six ounces
daily. The chemical tests on the urine and
FEBRUARY 1967
air reflected little change in either male or
female wards after the administration of
cranberry juice was begun.
The personnel, using their noses as guides,
reported more significant impressions. After
the first week of giving cranberry juice,
personnel noted that the odors were less
evident in the wards. As the dose was
increased, the odors became markedly re-
duced. It was also reported by the ward
personnel that the patients who had com-
plained of a burning sensation on urination
no longer complained of discomfort. Those
incontinent patients who had had a strong
odor about them seemingly had less odor
when receiving cranberry juice regularly.
The urine odor on clothing and bed linen
was reduced markedly.
During the administration of the cran-
berry . juice, no untoward reactions were
noted in any of the patients. - Excerpts
from Journal of Psychiatric Nursing, Sept-
ember, 1966.
Beautiful Eyes
Communication between adults has be-
come a highly sophisticated art, with the
result that true feelings are often lost be-
neath a protective covering of words. It is
a lack of such sophistication that makes
the speech of mentally retarded adults
childlike in quality. What we mistake for
stupidity in the conversation of retarded
adults is often a frankness and direct sim-
plicity so often absent in our more technical
manipulation with words.
Jerome Nitzberg, M.S.W., in the Sept.
issue of Canada's Mental Health, cites a
few examples of the disarming - if not
always rational - formulations of the re-
tarded. One young man with a talent for
leaving the floor dirty after mopping it,
sincerely explained that "the floor is too
big and the mop is too small." Another 32-
year old childishly explained why he ne-
glected to bathe more often: "I'll only get
dirty again!" A young woman, in explaining
why she wept so frequently, commented,
"My eyes are beautiful when they are full
of tears."
Employee Services Recognized
The presentation of long service awards
is well established in industry, but equally
industrious hospital employees often go
unrecognized. That is until recently, when
the Brockville General Hospital in Brock-
vme, Ontario, set a precedent by awarding
31 long service awards to personnel em-
ployed there for more than 10 years.
The director of nursing, Vera J. Preston,
proved to have the longest service of all -
over 25 years. Miss Preston, who began
employment with the hospital on March 1,
1938, received the top award of a gold
watch as well as a gold service pin for
"faithful devotion to her duties."
Miss Nora Towe, of the food service
department, received a 20-year gold service
pin, and Miss Gladys Edwards, supervisor
of the central supply department, who is
only a few months short of 15 years service,
received a 10-year service pin. Other nurses
with 10 years and more service were: Miss A
Foster, Mrs. S. Willows, and Miss Joan
Freeman.
All departments of the hospital were
represented, including housekeeping, engi-
neering, administration, and food service.
Burnt Cakes and Car Accidents
Insurance companies take note! From the
results of her "Experimental Study of Home
Accident Behavior," Dr. Joan Guilford,
director of the American Institutes of
Research in Los Angeles, concludes that
"one might speculate that a woman drives as
she keeps house." The frequency of accidents
in the kitchen appears to be related to the
frequency of those on the highway and to
vehicle code violations, a study of auto-
accident and violation records of 178 women
indicated. Further, the type of auto accident
- personal injury or property damage -
seems selectively related to those in the
kitchen.
Dr. Guilford, who conducted the experi-
ment using a mobile van with simulated
home kitchen and one-way observation
rooms, found that not only were home acci-
dents correlated with auto accidents and
traffic violations, but also that other factors
- the number of a woman's children, her
drinking habits, weight, personality traits
and blood pressure - were related in many
cases to accidents or near accidents.
What factors may "predict" kitchen (and
possibly automobile) accidents? One of the
best, most consistent indications - at least
in this study - was the number of children
each subject had. "It seems clear that those
subjects with more children have the lower
accident rates," said Dr. Guilford.
Other results indicated that when com-
pared to teetotalers, women who drank al-
coholic beverages were less likely to have
kitchen accidents. Emotionally unstable
women tended to have more personal-injury
accidents, but not property damage. Both
thin and obese subjects had more accidents
than did average-weight subjects.
THE CANADIAN NURSE 23
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contents
Introduction
Body Fluid, Our Heritage from the Sea
Cellular and Extracellular Fluid: Secretions and
Excretions
Units of Measure
Gains and Losses of Water and Electrolytes
Volume Changes in Extracellular Fluid
Composition Changes of Major Extracellular
Electrolytes
Position Changes of Water and Electrolytes of
Extracellular Fluid
The Role of Nursing Observations in the Diagnosis
of Body Fluid Disturbances
The Elements of Nutrition
The Nurse's Role in Preventing Imbalances of Water.
Electrolytes, and Other Nutrients
Help from the Lab
Gauges for Dosage
The Treatment of Body Fluid Disturbances
Parenteral Fluid Administration - Nursing
Implications
Fluid Balance in the Surgical Patient
Fluid Balance in the Badly Burned Patient
Fluid Balance in the Patient with Digestive Tract Disease
Fluid Balance in the Patient with Urological Disease
Fluid Balance in the Patient with Cardiac Disease
Fluid Balance in the Patient with Endocrine Disease
Fluid Balance in the Patient with Neurologic Disease
Fluid Balance in the Patient with Respiratory Disease
Water and Electrolyte Disturbances from Heat
Exposure
Fluid Balance Disturbances in Infants and Children
Bibliography
Index
To help save lives!
A new and vitally important book
on the nurse's role in prevention
of body fluid disturbances.
NURSES'HANDBDDK
OF FLUID BALANCE
Medical science recognizes that body fluid disturbances represent
the common denominator of a host of illnesses; that every patient
is a candidate for one or more of these disturbances; and that the
life of a patient may depend upon early recognition, interpretation
and intervention. Since the early recognition of fluid imbalance
depends upon close observation of the patient, the nurse carries
a heavy responsibility. She must be alert to adverse signs in the patient's
progress and must understand their significance.
Eminently qualified, the authors write with an insight into the
medical problems and nursing needs of patients with fluid imbalance
and provide the nurse - student and graduate alike - with a well-
illustrated, comprehensive and illuminating book on body fluid
disturbances. Emphasis throughout is on knowing what to look for
- how to look for it - and what to do about it. - The authors
first present general information concerning body fluid disturbances
- their nature, pathogenesis, clinical manifestations and diagnosis.
They then deal with the important clinical areas.
By Norma Milligan Metheny, R.N., M.S., Department of Nursing,
St. Louis Junior College, St. Louis, Missouri: formerly Medical-Surgical
Coordinator, Missouri Baptist Hospital School of Nursing, St. Louis.
William D. Snively, Jr., M.D., Clinical Professor in the Department oj
Pediatrics, Medical College oj Alabama; Vice President, Medical AI/airs,
Mead Johnson & Company: formerly Chairman, Fluid Balance Exhibit
Committee, American Medical Association.
275 PAGES
90 ILLUSTRATIONS
1967
$7.50
:::::::-L i P pi n C 0 it
------------------------
J. B. LIPPINCOTT COMPANY OF CANADA LTD., 60 Front Street West, Toronto 1.
Please send me
capy(ies) NURSES HANDBOOK OF FLUID BALAN<:E
$7.50
NAME
ADDRESS
CITY _.....
. . PROVo
FEBRUARY 1967
24 THE CANADIAN NURSE
o Payment enclosed
o Charge
CN 267
new products
{
Descriptions are based on information
supplied by the manufacturer and are
provided only aø a service to readers.
Pregslide
(BELL-CRAIG)
Description - A simple, inexpensive,
and highly accurate urine test for preg-
nancy. The Pregslide kit gives results in two
minutes with an accuracy of 97%. Because
of its high sensitivity, the new test can
detect pregnancy earlier than any other
slide test.
Procedure - To perform the test, two
prepared reagents are mixed with a single
drop of the patient's urine on a specially
tinted blue slide. The mixture will assume
a smooth and, finally, a granular pattern if
the patient is pregnant. In a negative test,
.agglutination (clumping) will be visible
within two minutes.
For information on the new pregslide
kit contact Bell-Craig Pharmaceuticals, 45 I
Alliance Ave., Toronto 9, Ont.
Showplace
(BREWSTER)
Description - This portable, table-top
exhibition panel unit is offered in a variety
of panel surfaces for use in hospital lob-
bies, for fund raising or general public
relations displays, and in nursing schools
for instructional exhibits.
The 25 lb. Showplace unit provides 24
square feet of exhibit space in two 24" x
36", two-sided panels encased in hard-
.l\Vood frames. The equipment comes com-
pletely assembled.
\
4.
I
'II
II
.p. \
1
4I -
The panel surfaces includes:
" thick
"doeskin" Homasote, V<I" thick pegboard,
'h" thick burlap-covered Homasote or V<I"
thick burlap-covered pegboard. Frames are
finished in walnut or driftwood.
The Homasote panels will accept picture
hoofs, nails, staples, pins and tacks, while
the pegboard versions take print clips,
hooks and shelves supplied by the manu-
facturer.
For further information, contact: The
Brewster Corporation, Old Lyme, Conn.
06371.
FEBRUARY 1967
Urecholine
(MERCK, SHARP AND DOHME)
Description - A new dosage size (25 mg.
tablet) for Urecholine chloride has been
added to the existing 5 and 10 mg. tablet
size and the 5 mg.l cc. injection form.
Urecholine chloride (bethanechol chlor-
ide) is a parasympathomimetic agent that
increases the smooth muscle tone of the
gastrointestinal and urinary tracts.
Indications - Urecholine chloride is
recommended in the treatment of certain
cases of postoperative urinary retention
and atony of the bladder, postpartum uri-
nary retention, postoperative abdominal
distention, and in congenital megacolon
when drug therapy is indicated.
Dosage - Dosage and route of admin-
istration must be individualized, depending
on the type and severity of the condition
to be treated. Mild and moderate disorders
often respond to the tablet. Subcutaneous
injection should be reserved for patients
who do not respond to oral therapy.
Oral: The usual adult dosage is 10 to
30 mg. three or four times a day. Satis-
factory response often follows 10 to 15 mg.
The minimum effective dose is determined
by giving 5 or 10 mg. initially and repeat-
ing the same amount at hourly intervals
to a maximum of 30 mg. until a satisfac-
tory response occurs. The effects of the
drug sometimes appear within 30 minutes
and usually within 60 to 90 minutes. They
persists for about an hour.
Subcutaneous: The usual dose is 1 cc.
(5 mg.), although some patients respond
satisfactorily to as little as 0.5 cc. (2.5 mg.).
The minimum effective dose is determined
by injecting 0.5 cc. (2.5 mg.) initially
and repeating the same amount at 15 to
30 minute intervals to a maximum of four
doses until satisfactory response is obtained,
unless disturbing side effects appear. The
minimum effective dose may be repeated
thereafter three or four times a day as
required.
Injection Urecholine chloride is for sub-
cutaneous use only. It should never be
given intramuscularly or intravenously,
since violent symptoms of cholinergic over-
stimulation are likely to occur. Atropine
is a specific antidote. A syringe containing
a dose for adults of 0.6 mg. (1/100 grain)
or more of atropine sulfate should always
be available to treat symptoms of toxi-
city.
Contraindications - Urecholine chloride
is contraindicated in hyperthyroidism, preg-
nancy, peptic ulcer, latent or active bron-
chial asthma, pronounced bradycardia or
hypotension, vasomotor instability, coron-
ary artery disease, epilepsy and parkin-
sonism.
Side Effects - Subcutaneous doses of
I cc. or less may cause such mild side
effects as abdominal discomfort, salivation,
flushing of the skin or sweating.
For further information or to receive
the Urecholine file booklet, contact: Merck,
Sharp and Dohme, P.O. Box 899, Mon-
treal 3, P.Q.
Literature Available
Patterns of Disease, a booklet published
six times yearly by Parke, Davis and Comp-
any, features "special reports" which would
be of interest to nurses.
Examples of the reports featured during
1966 are "Venereal Disease" (March-
April), "Speech and Hearing Disorders"
(May-June), "The Nation's Health Man-
power" (July-August), and "Gastrointes-
tinal Disorders" (September-October).
Composed of numerous charts, graphs
and illustrations, these reports offer a fund
of interesting facts.
Also published by Parke, Davis and
Company, Ltd., "as a service to physicians,"
is their booklet Therapeutic Notes - and
its French counterpart Notes Therapeuti-
ques.
Containing more description and fewer
charts and illustrations that the first book-
let, Therapeutic Notes features several
articles in an attractive magazine format.
Besides the regular "ten-second abstracts,"
articles on such topics as infectious mono-
nucleosis, bites and stings, and eye dis-
orders in the aging patient have appeared
in the past year.
Nurses can have their names added to
the mailing lists of either publication by
writing, individually, and specifying which
publication, to Parke, Davis and Company,
Ltd., 5910 Cote de Liesse Rd., Montreal 9,
P.Q.
The proceedings of the International
Symposium on Physical Activity and
Cardiovascular Health, which was sponsor-
ed by the Ontario Heart J;'oundation
together with the Ontario and Canadian
Medical Associations, are now available at
a cost of $3.00 each.
This Symposium, held in October, 1966,
included 31 speakers and 43 discussants
at a gathering of 550 persons in the various
fields of medicine and physical education.
Orders for the proceedings should be sent
to the Ontario Heart Foundation, 247
Davenport Road, Toronto 5, Ontario.
THE CANADIAN NURSE 25
help wanted in Antigua, Burundi,
Columbia, Ghana, India, Jamaica, Kenya, Madagascar,
Peru, Rwanda" Sarawak" Tanzania, Tchad" Trinidad" Uganda" and Zambia.
.
-
-,
it's your world.
These countries have a lot in common. Everyone is
no place for you if all you have to offer is lofty
ideals. These are countries that need realists-people
who are ready to get down to work. And come down
to earth. Literally. Don't kid yourself. . . signing up
with this outfit will mean slugging it out through a
tough, demanding job. That's the only way you'll fill
the needs of these countries. And who knows, maybe
you'll have a few of your own filled. What is CUSO?
It's a national agency created to develop and pro-
mote overseas service opportunities for Canadians.
It arranges for the placement of qualified men
and women in countries that request their
services. If you're sent to a country it's be-
cause they've asked for you. Or someone
like you. How does CUSO work? Abroad, it
works through different international agencies
who all assist in the placement of personnel.
In Canada it works through local co-ordinating
committees, located in most universities. but serv-
:: i
. W..
. . ,.f
ing the whole community. What kind of people are
needed? People who can adapt their skills and training
to a far-from-perfect environment. Nurses who are
able to cope with frustrating (and often primitive)
working conditions. Nurses who can train and super-
vise other nurses. Nurses who can earn respect,
and give it. Think about it. You'll know if you've got
what it takes. What is the selection procedure like?
Tough. Because we don't believe in sending underdevel-
oped people to developing countries. Preliminary
screening is carried out, where possible, by local
committees. CUSO then nominates candidates
to governments and agencies requesting per-
sonnel, who make the final selection. CUSO
also makes arrangements for preparatory and
orientation courses. How do you apply? Get
more information and application forms from
local CUSO representatives at any Canadian
.
university, or from the Executive Secretary ofCUSO,
151 Slater Street, Ottawa.
cuso
The Canadian Peace Corps
26 THE CANADIAN NURSE
FEBRUARY 1967
A glimpse of nursing
in the USSR
This article is a thumbnail sketch of observations made by Dr. Mussallem during
the Travelling Seminar on Nursing in the USSR last October.
Helen K. Mussallem
tI-
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.
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FEBRUARY 1967
THE CANADIAN NURSE 27
"Please fasten your seat belts. We
will be landing at Moscow's Interna-
tional Airport in a few minutes."
I looked out into the dark sky and
the clouds suddenly vanished. "Those
are the lights of Moscow," my com-
panion said, "and over there is the Red
Square. "
I felt a strange tingle of excitement
and wonderment. What is Russia really
like? What are the people like - the
nurses - the hospitals - the schools
of nursing? Is the Russian system of
nursing so different from ours? Now,
one of the dreams of my professional
life was about to come true: I was
going to find the answers to these
questions and a thousand others during
our month-long Travelling Seminar on
Nursing in the USSR.
The twain did meet
The link between the Canadian nurs-
ing tradition and the Russian practice
is tenuous, but, nevertheless, real.
During the Crimean War, while Flo-
rence Nightingale was organizing nurs-
ing services for the British Army, Dr.
Pirogov was organizing them for the
Russian. Although each had the same
basic objective, they never met to ex-
change ideas.
Dr. Pirogov continued his work after
the Crimean War, and organized all
levels of health personnel in Russia.
When the Soviet system of public health
services was inaugurated simultaneous-
ly with the establishment of Soviet
power in 1917, much of Pirogov's
system was retained.
After the Crimean War, Miss Night-
ingale returned to England where she
promoted and developed high standards
of nursing education and nursing prac-
tice. Her revolutionary ideas spread to
virtually aU English-speaking countries
Dr. Mussallem, Executive Director of the
Canadian Nurses' Association. was a mem-
ber of the WHO Travelling Seminar on
Nursing in the USSR. This article was not
submitted to the USSR Ministry of Health
for approval.
28 THE CANADIAN NURSE
in every part of the world.
Now, 100 years later, 23 nurses who
had been educated in modified patterns
of the Nightingale system, were to meet
with nurses and doctors of the Soviet
Union who were products of the Piro-
gov system.
Participants from many lands
My Travelling Seminar colleagues
were chief nursing officers in their own
countries and literally came from the
four corners of the world, or, more
exactly, from the six World Health
Organization Regions: Africa, Latin
America, Eastern Mediterranean, Eu-
rope, South-East Asia, and Western
Pacific. We were in the USSR to learn
about the entire health program and
especiaUy about nurses and nursing.
But we were to learn much more than
that. We were to see cities, towns and
villages in four Republics, meet the
people, view the treasures of the past,
participate in festivities, and return with
a better understanding of this vast
country of mystery, commitment, and
contrast.
Our colorful group convened at the
Central Institute for Advanced Medical
Studies in Moscow on October 6.
Native costumes from Japan, the
Sudan, India, Malaysia, Tanzania, and
other countries displayed the splendor
of the color spectrum.
In the minds of all were many
questions and some apprehension about
what lay ahead. Certainly the warmth
and friendliness of our colleagues in the
Soviet Union left nothing to be desired.
Even though the language barrier sep-
arated most of us, this was quickly
overcome through the six interpreters
who were always at our disposal.
Free health services
The Seminar was opened the first
morning by the Deputy Minister of
Health of the USSR who explained to
us the basic socialist principles on
which the health services are based.
We soon realized that it was essential
to have an understanding of these
principles to appreciate how the meth-
odologies had evolved.
The Deputy Minister spoke with
great feeling of the importance of
nurses. He said that he hoped this
Seminar would be more than an ob-
servation of the health and nursing
services in the Soviet Union and that
the nurses from the countries repre-
sented would share their experience
with their Soviet counterparts. This we
did.
The Minister told us that when
Soviet power was established in 1917,
the importance of health care was re-
cognized, and its availability to aU citi-
zens, even in the most remote areas,
was regarded as a vital function of the
state. The constitution of the USSR
states emphatically that each individual
has a right to maintenance in sickness,
disability and old age. AU health ser-
vices are available free to all citizens
( and to visitors, as we were soon to
learn) in the Soviet Union.
We were impressed with the great
improvements made in health services
since 1917. For example, at that time
there were 46,000 middle medical
workers - the group to which nurses
belong, 1.4 doctors per 10,000 popu-
lation, and 13.0 hospital beds. The
average life span was 44 years. Today,
there are 1,620,000 middle medical
workers, 23.2 doctors per 10,000 po-
pulation, and 93.1 beds. The average
life span is 66 years for men and 73
for women. The measures used to ac-
complish these improvements were a
revelation to us.
Central control for health services
Major planning for all health ser-
vices in the 15 republics is a function
of the Central Ministry of Health in
Moscow. Here, the regulations for the
administration of all hospitals -
including nursing services - are
established. These regulations cover all
sizes of hospitals from the large, com-
plex, oblast hospitals in the metropo-
litan areas to the very smaU feldsher.
and midwife units on collective farms
in remote parts of this immense
· A feldsher is a category between physi-
cian and nurse: a "junior doctor."
FEBRUARY 1967
.
-
-r ,
country .
We toured all types of hospitals and
health services in which nursing was
involved, in four of the Republics:
... "'" Russian, Ukranian, Georgian, and Ab-
khazian Autonomous Soviet Socialist
Republic. In these republics we visited
large cities, such as Moscow, Kiev,
, Tbilisi, and Vinnitsa, and small com-
munities, such as Sukhumi, and Tul-
chinsk. We noted that the patterns
of health service in every community
generally followed the regulations spe-
cified by the Central Ministry in
Moscow.
-
, Labor code protects worker
, The administration of nursing ser-
,.,. vices in the hospitals is unlike that of
Canada. The main differences stem
. from the differences in ideologies and
\ . basic principles of management. In the
i ,. ( ..
\ USSR, legal regulations govern the em-
ployment of all workers, including
those in medical and paramedical fields.
) The labor code gives protection to the
worker and certain statutory powers to
the trade unions. These are related to
such matters as improvement of work-
ing conditions and scrutiny of the
f labor legislation.
, The legal labor regulations of all
citizens are founded on principles of
- socialist management of labor as con-
tained in the Constitution. We were
\ told by the head of the Labor Pro-
tection Department at the Central Com-
mittee for Medical Workers that the
fundamentals of socialist labor legisla-
,í' tion include:
1. The universal obligation to work.
2. A guaranteed right to work.
3. Guaranteed remuneration of work
depending on the quantity and qua-
, - lity of that work.
..... 4. A labor discipline and the ob-
...... servance of internal labor regula-
tions.
5. Guaranteed safety and health con-
ditions of labor, legislation restric-
tions on working hours, and a
I guaranteed right to rest.
.. 6. Assistance in the improvement of
qualifications and general educa-
tional standards of workers and the
right to assistance and maintenance
FEBRUARY 1967 THE CANADIAN NURSE 29
in case of disablement as determin-
ed by the law and at the expense
of the State.
Everyone works for the State and is
paid by the State. There is no private
enterprise, nor is there private practice
by doctors, nurses or any other
workers. Physicians, nurses, and other
health workers are assigned to hospitals
on a full-time basis. Public health
functions are carried out by personnel
of polyclinics, dispensaries, and felds-
her units who visit and give health care
in the home or anywhere in the com-
munity.
All workers in the health field -
doctors, nurses, and even students -
belong to the same trade union. There
is no voluntary professional associa-
tion like the CNA. Membership in the
trade union provides generous benefits
in relation to housing, vacation and
recreation. Individual excellence and
achievement is rewarded through addi-
tional money or through the provision
of better living accommodation.
Living accommodation for nurses is
arranged by the State and is provided
at a very minimum rate - usually at
five rubles (approximately $5.00 Cana-
dian funds) per month. It is difficult,
however, to compare nurses' salaries in
the USSR with salaries paid to their
counterparts in other countries, since
the economic systems are basically
different. When we acknowledge that
so many services are provided - full
maintenance during retirement, holi-
days at very minimum expense, in-
expensive food and clothing - we then
recognize that the nurse's wages, from
60 to I 10 rubles a month, are quite
sufficient to provide a comfortable
living and enjoyment of the recreational
and cultural offerings. For comparison,
doctors are paid. about 100 to 150
rubles per month.
No nursing hierarchy
The chief physician in every hospital
is also its chief administrative officer.
The chief nurse is directly responsible
to this doctor and, essentially, is his
assistant. The senior nurse of a depart-
ment is directly responsible to the
30 THE CANADIAN NURSE
senior physician and works under his
direct supervision. Together they super-
vise the nursing services provided in
that department or unit.
There is no nursing service depart-
ment and no direct line of authority
between the chief nurse, the senior
nurse, and the staff nurse. "We do not
believe in a nursing hierarchy," I was
told. Essentially, the doctor, nurse, and
auxiliary personnel work together as a
team, with the doctor in charge. This
pattern also prevails in polyclinics and
in other health units.
Often we received the impression
that duties were interchangable and
that the person most available at the
time performed the necessary task -
such as assisting a patient back to bed
or holding a crying infant. It was diffi-
cult to identify the various categories
of personnel since all wore the same
uniform - a white smock over street
clothes and a white "surgeon's hat."
Also, the majority of personnel in the
health services are women, which adds
to the identification problem. About 70
to 75 percent of the doctors, the ma-
jority of the feldshers, and all of the
nurses are women.
Staffing of medical services
Three categories of workers provide
health care: the upper medical workers,
which include physicians and stomoto-
logists (dentists); the middle medical
workers, which include the nurse,
feldshers, and midwives; and the lower
medical workers, who act as assistants
to the middle medical worker.
The staffing patterns of hospitals -
oblast, rayon, uchastock, polyclinics,
etc. - are determined by special re-
search and laid down in regulations
by the Central Health Ministry in
Moscow. However, each hospital is
permitted to have more personnel in
various categories, provided the request
is justifiable. We were told that addi-
tional staff could be requested from the
personnel office of the appropriate
institutions at any time. The ratio of
staff to patients varies according to the
severity of illness and the age group.
For example, the ratio is more favor-
able in units for acutely ill children
than in units for convalescents. In a
children's hospital the ratio may be
one nurse to 6, 8, or 12 patients, and
in a convalescent unit, one to 25.
Doctors, too, are on the wards full
time.
Everyone works
The Trade Union carefully regulates
the hours of work for each citizen. The
total work week is usually 41 hours
with additional remuneration provided
for overtime.
Usually a hospital department has
two shifts of nurses who work a six
and one-half hour day; however they
may work up to 12 hours. In some
institutions, a nurse may work for 24
hours and then be off duty for the
next two days.
Everyone in the USSR has both the
obligation to work as well as the right
to work. Unlike the situation in most
countries represented at the Seminar,
the Soviet nurses work for their normal
span of years regardless of family
status. They are allowed maternity
leave of 56 days prior to and 56 days
following the delivery of a child, and
their children are cared for in creches
or by relatives.
Each health worker is required to
work where she is assigned for the
first three years after graduation. After
this she may move to a hospital of her
choice, but her freedom of movement
is somewhat controlled by various
methods. Following the three years of
work in the assigned area, usually in
a rural part of the country, nurses
specialize in various fields such as diet
therapy, physiotherapy, electrocardio-
graphy, operating room assistant, phar-
macy assistant, etc. Indeed, it is cus-
tomary for her to continue with spe-
cialization, but she usually has the right
to choose the specialty she will pursue.
Thus, there is not a proliferation of
professioñs or occupations in hospitals,
but rather one profession with various
degrees of specialization.
"Bolshoi spasibo"
Throughout our whole tour, both in
FEBRUARY 1967
the hospitals and ministries, the warm,
friendly hospitality overwhelmed us.
We quickly learned to say "spasibo"
for thank you; however, because of the
abundant hospitality, we asked our in-
terpreters for a word that expressed
more than that, and soon progressed
to "bolshoi spasibo." At every institu-
tion we were greeted in a room that
had tables filled with cut-glass com-
potes of grapes and apples. Candies,
booklets, and small broaches that de-
picted their famous men were distribut-
ed freely. Before we left, the nurses
always came to our transport with a
bouquet of flowers for each of us.
The hospital visits usually began
with greetings from the chief doctOl:
and chief nurse. With the portable si-
multaneous translation equipment and
six interpreters, the language barrier
almost disappeared. Following intro-
ductions, we toured the departments
and were able to ask questions and re-
ceive answers "on the spot."
The size of departments and number
of rooms depended on the nature of the
hospital. In general, the patient settings
were not unlike those in many Cana-
dian hospitals except, in the hospitals
we toured, the patients' beds were
closer together. Usually five beds rather
than three or four occupied a ward.
The wards were very white: white
beds, white linen, white walls. The doc-
tors and nurses all wore white hats and
gowns over their street clothes. Some-
times we, too, donned the white gown
and hat. The patients appeared to be
well cared for and we sensed a warm
relationship between them and the staff.
In particular, we noted the very sensi-
tive care provided for sick children. In
the children's hospital more color was
used and there was a less regimented
appearance.
The operating rooms, polyclinics,
and other health services had a physi-
cal appearance not unlike those in Ca-
nada, even though the categories of
workers and their relationships were
different.
The nurses in each department of
the hospitals worked under the direc-
tion of the physician and as his assis-
FEBRUARY 1967
tant. The doctor generally carried out
all medical procedures, including blood
transfusions, intravenous and intramus-
cular injections.
A typical school of nursing
What are the schools of nursing like
in Russia? My visit to one of the
middle medical schools gave me some
insight. After a very warm greeting and
a lecture by the director, a woman
physician, we toured the school.
The classrooms were bright and
cheerful and the nursing students look-
ed young and lively. As we went from
room to room we saw them practicing
procedures - procedures - proce-
dures. In the first classroom they were
practicing bandaging, and they all look-
ed so attractive even with the bandaged
eyes, limbs and bodies. They had on
clean white smócks over street clothes
and white caps. I went over to speak
to a small group without an interpreter.
"Pajolsta," I said and they knew it
meant "please." It was one of the few
Russian words I knew and I was mere-
ly trying to comment. However, they
unwrapped the bandages and put them
on all over again. They were tickled
when I tried to speak in Russian from
my Guide Book. The interpreter came
to my rescue, but I refused. "Bolshoi
spasibo." Nurses do not need interpre-
ters in these situations.
But there were more than nurses
being prepared in this middle medical
school. Feldshers, midwives, children's
nurses, laboratory technicians, and
other health personnel also attend this
school to receive their training.
The education of these workers, as
for all workers, is free. The Ministry of
Public Health in the USSR has a De-
partment of Medical Education that
deals with all matters pertaining to
every level of health worker education.
The Minister is responsible for plan-
ning and approving the curriculum,
which is uniform for all 630 schools in
the 15 constituent republics. Each of
the republics has its own Minister of
Health who is responsible for supervi-
sion and guidance at the local level.
However, the Central Ministry in Mos-
cow retains the function of inspection
of the educational program as well as
revision of the curriculum.
There are more than 330,000
students in the 630 middle medical
schools, with the largest percentage
being prepared as nurses. The length of
the educational program for nurses de-
pends on the student's educational
background. For example, if the stu-
dent has 8 years of schooling (incom-
plete secondary education), the length
of the course is 2 years and 10 months;
if she has 10 years of schooling (com-
plete secondary education), the course
is I year and 10 months.
Courses taught by physicians
Physicians administer the middle
medical schools and teach all the nurs-
ing subjects. Although no nurses are on
the staff of the middle medical schools,
they sometimes supervise students in
the clinical field. General education
subjects, offered to those with incom-
plete secondary education, are taught
by general education personnel.
One middle medical school that we
visited prepares 1,200 students, of
whom 780 are nurses. This ratio is
fairly common for all middle medical
schools throughout the Soviet Union.
The teachers are physicians, but do
not have special advanced preparation
in pedagogy. Instead, committees on
methods of teaching are formed to im-
prove the method and quality of the
educational program in the schools.
The teachers at the middle medical
schools are usually on the medical staff
of a nearby hospital where students
obtain their clinical experience. They
keep current on new medical advances
by attending the Institute for Advanced
Medical Studies where special courses
are available.
Recruitment not a problem
At the present time, recruitment of
students into nursing is not a problem.
We were told that to expand the USSR
health programs to the desired level,
a larger number of nurses and other
medical personnel is required. Last
THE CANADIAN NURSE 31
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32 THE CANADIAN NURSE
FEBRUARY 1967
year, 107,000 students were admitted
and 120,000 admissions are planned
for this year. The teachers from middle
medical schools visit secondary schools
to talk about nursing as a career, and
prospective students are invited to
"open door days" at middle medical
schools. When students visit the middle
medical schools, the teachers explain
the program and the opportunities
available. Married students with or
without children are permitted to enter
the school and those who become preg-
nant are given academic leave. There
are no student organizations, but stu-
dents have the option of becoming
members of a trade union. This mem-
bership offers many advantages and
almost 95 percent of the students join
during their first year.
Curriculum set by educators
Unlike Canada, where the control
of educational programs is centered in
service agencies, the program of in-
struction in the USSR is prepared by
an educational board of the Ministry of
Public Health. Members of this board
are experienced and highly skilled spe-
cialists. They meet periodically to re-
vise the common curriculum and the
academic program for the middle med-
ical schools throughout the consti-
tuent republics. This board also out-
lines the ways in which the curriculum
should be implemented, prescribes the
textbooks to be used, and selects the
authors to write the textbooks.
The following pattern is used for
all schools of nursing throughout the
country. Each year is divided into two
semesters. The first semester begins
September 1 and lasts until January
11; the second begins January 26 and
lasts until July 5. All students have
winter vacation from January 12 to 25,
and summer vacation from July 6 to
August 31. The students have a 35-
hour week and a 6-hour day. This time
may be spent on theory, practice or
visits, depending on the level of the
student in the educational program.
The curriculum is divided into three
cycles: cycle one is devoted entirely
to general education; cycle two, to
FEBRUARY 1967
general medical subjects, as well as to
anatomy, physiology, pharmacology
and biology; and cycle three, to the
special or clinical subjects, which in-
clude general care of patients, surgical
diseases, obstetrics and gynecology,
children's diseases, eye diseases, etc.
The total planned hours of the curricu-
lum are 3,774, of which 2,516 are
devoted to class work and 1,228 to
practical experience.
The objective of the course for the
preparation of nurses is "to train future
nurses in the tending of patients and
in medical skills." A review of the
curriculum and observations made dur-
ing visits at middle medical schools
revealed that the educational program
is disease and procedure-centered, with
emphasis placed on medical equipment.
Diseases and health teaching are em-
phasized. Only a very small portion of
the outline stresses the practice of
nursinE! as an art and a skill.
At the completion of the basic edu-
cational program, students write State
examinations. Successful candidates re-
ceive a diploma of certification and
are then assigned to a place of em-
ployment for three years. The top 5
percent in any graduating class are en-
couraged to proceed to the higher med-
ical institutes to become doctors -
and the majority do. The remainder
of the students who complete the three-
year assignment may, until they are 30
years of age, apply to the higher medi-
cal institutes to become doctors.
Often we were told during the Tra-
velling Seminar that the goal of most
middle medical workers, including
nurses, is to become a physician, be-
cause "nurses conduct medical treat-
ments and apply medical equipment
only in accordance with prescriptions
and instructions of the physician in
charge of the patient."
Unlike the Canadian system, all stu-
dents attending middle medical schools
live at home or in special apartments.
The only exception to this is when the
middle medical schools are located in
the far north or where the homes of
the students are a long distance from
the school.
A window in the iron curtain
Although the program was very full
with little time for relaxation, we man-
aged to squeeze in a swim in the Black
Sea. The same night we packed for the
twelfth time and returned to Moscow
to complete our assignment. On the
next night, our last in Moscow, the
Ministry planned a dinner party for us.
After the party, a companion and I
walked up Gorky Street to the Red
Square. I shall never forget the beauty
of the moment when we looked through
the falling snow across the Square.
There were the beautiful cathedrals
with their gold bubble domes accen-
tuated by the soft flood lights. I looked
over to Gums Department Store where
we had struggled in queues to make
small purchases, then back to Lenin's
tomb with the young soldiers standing
stiffly on guard. Then, into my view
came the gilded crescent and the five
pointed red stars of the Kremlin, muted
now by the falling snow. I could feel
the past and the future there, but main-
ly the throbbing of the present.
We turned and trudged back to our
hotel. We hardly spoke. I was thinking
of all we had done and seen in the
past month, the nurses and doctors we
had met, and how committed they were
and how far they had come in so rela-
tively short a time. I realized that they
were very much like all of us going
out to work each day, coming home
each night, and living their lives much
as we do.
Those of us in the first Travelling
Seminar on Nursing in the USSR re-
turned to our native lands with many
different impressions. We all agreed,
however, that it had been a rewarding
and exciting professional and personal
experience. For us there are now win-
dows in the Iron Curtain. 0
THE CANADIAN NURSE 33
Estrogen replacement therapy
at menopause
John Fitzgerald Kennedy, in his in-
augural address, challenged the 1960's.
He called on a new generation to find
better solutions for old problems in a
rapidly changing world. In medicine,
a steroid revolution became one of
the fascinating developments of this
decade as two new freedoms, closely
allied, reached fulfillment for many
women: freedom from undesired preg-
nancy and freedom from premature
old age.
The impact of oral contraception
on our generation needs little com-
ment. Ten million women throughout
the world now use these estrogen-pro-
gestogen combinations for ovulation
control and/or therapeutic purposes.
Their safety and effectiveness have
been repeatedly demonstrated by in-
numerable government agencies and
concerned medical investigators. Minor
problems, experienced by a small per-
centage of patients, capture dramatic
newspaper and magazine discussion;
for the "pill" causes symptoms similar
to those of pregnancy, and with about
the same frequency. Variations in the
chemical structure and dosage of the
constituent steroids will evolve; but
oral contraceptives arc here to stay,
and doctors and patients, politicians
and sociologists must now adjust to
their astonishing role in modern so-
ciety.
Most oral contraceptives inhibit
normal pituitarv ovarian function, so
that these medications substitute for
circulating steroids usually obtained
34 THE CANADIAN NURSE
The average woman outlives her ovaries by 25 years. Estrogen from the corner
drug store will correct this deficiency more naturally than
tranquilizers and psychotherapy.
Donald C. McEwen, M.D., F.R.C.S. ( C), F.R.C.O.G., F.A.C.O.G.
, "
Dr. McEwen. a graduate of the University
of Manitoba, is an Obstetrician and Gyne-
cologist in Calgary. Alberta. He is on the
staff of the Calgary General, Grace. Rocky-
view, and the Holy Cross Hospitals.
from normal ovarian function. It is
not widely appreciated that in pre-
scribing these agents, a doctor creates
ovarian deficiency and, paradoxically,
treats it at the same time; for with
treatment, ovarian function becomes
one of suspended animation.
Some doctors, willing to prescribe
these powerful drugs to young women
with normal ovaries, remain reluctant
to offer similar hormones to women
suffering from true ovarian deficiency,
a result of normal aging, congenital
insufficiency, disease, surgery, or ra-
diotherapy. Little attention was paid
to the menopause in medical school.
Most doctors were taught that the
menopause was a natural phenomenon,
hormone treatment potentially danger-
ous and one to be condemned from
a long-term point of view.
The concept of ovarian deficiency
as a medical entity is, however, gain-
ing recognition. If it is a valid clinical
condition, one in every three women
alive is a victim to a greater or lesser
degree. Ovarian senescence may be
rapid or gradual; but the result is the
same. Estrogen blood levels decline,
ovulation does not occur, and pro-
gesterone is not elaborated. The meno-
pause, or failure of menstruation, oc-
curs when these hormones are insuf-
ficient to ripen endometrial tissue. The
climacteric encompasses a wider span
from the time ovarian function falters
until that occasion when total failure
occurs, usually about age 60. Ovarian
dysfunction is a frequent occurrence
FEBRUARY 1967
after the age of 35, so many women
will suffer ovarian deficiency or im-
balance for half their lifetime.
Symptoms of menopause
Symptoms suggesting an impending
menopause are well known. The hot
flush, usually the first symptom, is a
sudden sensation of heat in the upper
part of the body often associated with
a patchy redness of the skin. Perspira-
tion and a feeling of chilliness may
follow. Hot flushes seem to be more
common with increased heat produc-
tion (stress, exercise, a hot room) or
when heat loss is impaired (sultry
weather, heavy bedclothes). Sleep is
frequently disturbed and insomnia be-
comes a common complaint.
Pituitary overact ion may cause the
hot flush as gonadotropin levels rise
to stimulate estrogen production from
aging, unresponsive ovaries. It may be
due to fluctuating levels of estrogen.
Excessive production of other pituitary
tropic hormones results in an increas-
ed stimulation of adrenal, thyroid and
pancreatic glands, resulting in further
systemic disturbance.
- Fatigue, depression, and emotional
instability may be unusually trouble-
some at this time. Such symptoms may
be sensitive barometers of estrogen
deficiency, or may be a reflection of
pituitary hypothalamic turmoil, or be
simply manifestations of environmen-
tal emotional influence (husband, fami-
ly or social upheaval).
The signs and long-term effects of
estrogen deficiency are much more sig-
nificant. The major physical hazards
are degeneration and atrophy of uro-
genital tract and breasts, blood vessels
and bones; but the whole body is af-
fected by a lack of estrogen. Aging
may be accelerated and joie de vivre
disturbed, modified from patient to
patient by variations in the degree of
ovarian failure, individual sensitivity
to estrogen deprivation, the patient's
emotional strength, called motivation,
her ability to handle stress, and the
infinite vicissitudes of life.
Atherosclerosis
Until the menopause, women are
FEBRUARY 1967
relatively immune to coronary artery
disease, but thereafter become more
susceptible. Many observations have
been made on the effects of castration
on atherosclerosis. Castrated young
women have rates of arterial disease
similar to men of the same age. Re-
moval of ovaries at hysterectomy
brings about a fourfold increase in the
degree of coronary artery degeneration
when compared to women whose ova-
ries are left. Replacement therapy with
estrogen lessens this risk in women.
In controlled studies of men who had
coronary infarction or strokes, the use
of natural estrogens produced signifi-
cantly longer survival and reduced the
occurrence of secondary occlusive epi-
sodes. Long-term studies exploring
these possibilities continue to excite
medical investigators.
At present, the lesson is quite clear.
Normal ovaries should be retained at
the time of hysterectomy and replace-
ment ovarian therapy is strongly indi-
cated for those patients who show
evidence of hypertension or cardio-
vascular degeneration.
Osteoporosis
Postmenopausal osteoporosis of va-
rying degrees occurs in practically all
women. The degree of mineral loss
is directly related to the severity of
ovarian failure and the elapsed time
of estrogen depletion from all body
sources. This is an insidious, overlook-
ed, and sometimes crippling disease. It
may manifest itself clinically by low
back pain from even minor trauma,
shortening of stature, or dorsal kypho-
sis (dowager's hump). Loss of density
of bones by roentgenograms is a late
sign. Elderly women fill our orthopedic
wards with fractured hips, and many
more who pass through the later stages
of life suffer much distress from back
and pelvic degeneration. Men do not
suffer this affliction with any signifi-
cant frequency.
The cause of osteoporosis remains
debatable; but the consensus of opinion
suggests it is due to increased bone
resorption resulting from long con-
tinued negative calcium balance.
Estrogens taken orally constitute
the most effective and universally ac-
cepted treatment of osteoporosis, asso-
ciated with physiotherapy to restore
maximum physical activity, and dietary
regimens to supply sufficient minerals,
and to keep patients in positive nitro-
gen balance.
Genital atrophy
It is estrogen that brings about t.he
metamorphosis of a girl to a woman,
stimulating breasts and genital tract
and the whole body to maturity. It is
the withdrawal of estrogen at the time
of ovarian failure that reverses this
process. Resorption of fat and loss of
elastic tissue make breasts and external
genitalia smaller and less full. The
vulva becomes thin, irritable, and often
itchy. The vagina and uterus become
small and atrophic, supporting struct-
ures weaken, and genital prolapse is
a frequent consequence. Urinary tract
tissues share this estrogen dependency.
and urinary dysfunction manifests by
urgency, frequency, and urinary infec-
tions. Stress incontinence also may be
part of a common and stubborn defi-
ciency syndrome.
There is, therefore, considerable
evidence that estrogen is protective to
the mature woman, her cardiovascular
system, bones, genital tract. joints,
skin, and possibly every tissue in her
body. Estrogen offers protection against
psychological involution, apathy and
negativism. The logical conclusion
must be that adequate estrogen levels
should, if possible, be maintained in
women; that estrogen throughout a
whole lifetime offers hope for positive
health.
Clinical study of ovarian deficiency
For the past three years this con-
cept has been explored in some depth.
By September 1966, 777 women with
symptoms and signs of ovarian defi-
ciency of varying degrees were consi-
dered for supplemental or replacement
estrogen therapy. Thousands of pa-
tients appeared in other doctors' of-
fices as the potentialities of this therapy
became known throughout the female
population .These negìected women in-
dicated in the only way possible their
THE CANADIAN NURSE 35
personal concern and disenchantment
for traditional treatment of the meno-
pause.
A variety of treatment schedules
to manage different clinical situations
and to individualize patient needs is
essential. These can be broken down
into two simple types: treatment for
the patient whose uterus has been re-
moved, and treatment for the patient
whose uterus is intact.
1. The patient whose uterus has
been removed: These patients simply
require sufficient daily estrogen to
achieve maximum well-being and re-
store vaginal maturation indices to
normal. A progestogen alone or com-
bined with added estrogen may be
added for five days a month for ba-
lance; but this is not essential, for en-
dometrial shedding is not required. The
metabolic action and biological need
of progesterone-like steroids remain
obscure and ill-defined at the present
time.
Natural estrogens (conjugated estro-
gens, equine), marketed as Premarin,
are preferred as the selected estrogen,
being well-tolerated, effective, and
uniquely beneficial in the treatment
and prevention of atherosclerosis.
2. The patient whose uterus is in-
tact: Most patients who have not had
hysterectomy fall into four groups:
age 35-50 (perimenopausal); age 50-60
(menopausal); age 60-70; and age 70
upward.
Age 35-50 (perimenopausal):
If ovulation control is desired, one
of the combined or sequential estrogen-
progestogen packets will fulfill treat-
ment purposes. Individualization is
essential. The combined tabulation is
indicated where menorrhagia has been
a problem to reduce both the duration
and quantity of bleeding. The sequen-
tial package is preferred where there
has been gross disturbance of the
menstrual cycle, particularly if bleed-
ing has been scant or painful.
If ovulation control is not impor-
tant, natural estrogens (conjugated es-
trogens, equine) are useful and well-
36 THE CANADIAN NURSE
tolerated, and are prescribed from
Day 1 to Day 21 of each cycle. One
of the combined tabulations completes
therapy from Day 22 to Day 26 to in-
duce medical curettage on Day 28.
This cycle can be easily modified for
convenience by shortening or prolong-
ing the estrogen phase.
Age 50-60 (menopausal):
The patient with gross ovarian de-
ficiency, as indicated by failure of
menstruation, hot flushes or other
symptoms and signs of the menopause,
requires sufficient daily estrogen to
satisfy her needs as determined by
relief of symptoms and, helpfully, but
less important, by the vaginal cyto-
gram. Once this has been accomplish-
ed with the use of conjugated estro-
gens, (equine 0.625 mg. to 2.50 mg.
daily), medical curettage is induced
monthly with one of the combined es-
trogens and progestogens. in doses of
0.5 mg. to 2 mg. of the progestogen
for 5 to 10 days, in addition to the
basic daily therapy with natural estro-
gens. The dosage and duration of this
medical curettage regimen is indivi-
dualized after a few months according
to the patient's behavior, the length
and amount of menstrual flow, well-
being, etc.
Patients are allowed to decide the
day of their menstrual flow by simple
instructions; menses will occur two to
three days following cessation of the
medical curettage tablets. The menstru-
al flow should be scant, short, and
without significant distress. There
however if intermenstrual bleeding
after the first two months of therapy;
however if inter-menstrual bleeding
occurs, diagnostic curettage is indi-
cated particularly if the bleeding does
not respond to increased estrogen dos-
age.
· Mestranol O. J mg. and ethynodiol diace-
tate, .S mg., J mg. (Ovulen), and 2 mg. (Me-
tnden) were used in 55 percent of patients
in this series, and
re supplied by G.D.
Searle and Company of Canada.
Age 60-70:
After the age of 60, the production of
endogenous male hormone subsides to
low levels. If continued menstruation
is objectionable, the regimen may now
be changed to one of a combined es-
trogen and androgen tablet for cycles
of 25 days a month. The patient's well-
being, a positive nitrogen balance, and
adequate vaginal cornification indices
are maintained. Menstrual function
comes to an end, although in some
patients slight withdrawal bleeding may
occur when therapy is interrupted.
Age 70 upward:
Small amounts of estrogen, andro-
gen and geriatric vitamins given in
combined tabulation for 25 days a
month have been found most useful
to maintain vigorous old age, with
local estrogens given vaginally for uro-
genital integrity.
Such regimens allow easy individual-
ization of each patient. The objective
of this program is to extend middle
age for women by 10 years, and, there-
after, to supply supportive anabolic
steroids into old age. Sufficient ex-
perience has now been obtained to in-
dicate that this can be accomplished
with few treatment problems. Such
therapy appears safe, inexpensive and
rewarding in its physical and emotional
benefits. The basic concept of treat-
ment is similar to the use of thyroid in
myxedema, or insulin in diabetes mel-
litus.
Discussion
If there is a need for lifelong estro-
gen, and if treatment is easy, what then
are the usual arguments against such
therapy?
Estrogen-Cancer Relationship
No convincing proof that estrogen
has caused cancer in a human being
has ever been established, in spite of
a widespread feeling among some doc-
tors and some laity that the opposite is
true. Cancer of the breast is more
treacherous in pregnancy when estro-
gen excretion levels are extremely high;
but this association is rare, having an
incidence of about three breast cancers
FEBRUARY 1967
in 10,000 pregnancies. In endometrial
cancer, there may be evidence of a
long-standing estrogen influence, and
this lesion occurs with increased fre-
quency in association with estrogen-
producing tumors of the ovary, and in
ovarian polycystic disease (Stein-Levin-
thai syndrome). This association does
not indicate any definite carcinogenic
relationship, but likely reflects an ab-
sence of progestational medical cu-
rettage, for cyclic menstruation is ca-
ture's method of endometrial deter-
gence.
The rarity of cancer in women with
normal ovarian function, the insigni-
ficant number of reported cases of
breast or genital cancer in women
taking birth control pills or other es-
trogen therapy, the absence of experi-
mental evidence that estrogen incites
cancer, suggest there is little signifi-
cant estrogen-cancer relationship.
Continuing Menstruation
Menstrual function is not a pleasant
phenomenon. A waste of time, messy,
expensive, often uncomfortable, it is
understandable that, for most women,
the menopause offers welcome relief
after about 400 monthly cycles, less
the normal interruptions of pregnancy
and lactation.
But menstruation is an excellent
monitor of ovarian and uterine func-
tion. Normal cyclic menstruation is a
reassuring indication that physiological
replacement ovarian therapy has been
achieved. Women with ovarian de-
ficiency obtain maximum benefit if
normal estrogen-progestogen levels of
these hormones are created. A
natural consequence will be menstrua-
tion. This is accepted by most patients
in the 50 to 60 age group when its
significance is discussed. These women
consider menstruation a small price
to pay for relief from menopausal
symptoms, with the additional pos-
sibility of delayed aging of many vital
organs and functions.
Expense
Replacement ovarian therapy costs
between $15.00 and $50.00 per year,
depending on the steroids selected and
FEBRUARY 1967
the desired replacement. Cigarets cost
$150.00 a year; weekly hairdressing
averages $200.00. This therapy must
be considered inexpensive in any com-
parative study with clothes, cosmetics,
alcohol or travel.
Tampering with Nature
This argument is the most superficial
of all. Doctors, nurses, and the healing
professions generally, wage a constant
battle against nature's hazards. Anes-
thesia, modern surgery, antibiotics,
blood transfusions, immunization, and
pasteurization are examples of tamper-
ing with nature. And who would argue
against their use? The person who be-
lieves that the menopause is a natural
process defies nature every day by
wearing clothes, eating foods or driving
cars. Modern man flies against gravity
and sends rockets to the moon.
Nature has fallen behind medical
progress, for the average woman will
outlive her ovaries by 25 years.
Estrogen from the corner drugstore
will correct this deficiency more natur-
ally than tranquilizers and psycho-
therapy.
What About Men?
The argument that there are already
too many elderly women and widows
in the world, and the question "What is
to be done for men?" is much more
pertinent. Doctors interested in this
concept for women are concerned with
adding abundance rather than years to
life. In men, male hormones, hyper-
tension, and atherosclerosis are bad
associates, particularly when linked
with the stress of the market place,
unfulfilled ambition, cigaret smoking,
obesity, and lack of physical fitness.
These influences become complicated
when assessed individually. Generally,
to the extent that a menopausal wife
can, with hormones, enjoy a fulfilled
middle age, men can approach the 50's
certain that their wives will remain
feminine - emotionally, physically,
and sexually - down the road of life.
It is hoped that this may be a strong
influence on longevity as the other
problems of male aging are studied and
conquered.
Summary
The case for lifelong estrogen for
women has been discussed. Experience
in studving 777 women who have been
assessed for this treatment suggests
overwhelming acceptance of the basic
concept. There is need for wide appli-
cation of its potential benefits to the
millions of women suffering actively
or passively from ovarian deficiency,
particularly after the menopause. 0
THE CANADIAN NURSE 37
A wealth of articles recommendmg
the use of estrogen both before and
after the menopause have appeared in
the literature of the medical and para-
medical professions for several ye.ars
now. Some authors have even sug-
gested cyclic administration of an es-
trogen-progesterone combination de-
signed to restore a menstrual pattern
in the menopausal woman. Whether
or not the woman herself is desirous
of such a result would appear to be
a legitimate question. As one outcome
of this literary deluge, many persons
have wondered about and questioned
the value of estrogens as a sort of
legendary Fountain of Youth able to
rejuvenate anyone who bathes in its
waters.
Two distinct philosophies can be
gleaned from the mass of literary opin-
ion on the subject of the menopause
in general. On the one side we have
those who consider the menopause as
an illness and consequently believe that
the climacteric woman should receive
compensatory hormonal therapy in-
definitely, however minor her symp-
toms. On the other side are those who
view the menopause as a period of
physiological adjustment or adaptation
to a new phase of life and who reserve
hormonal therapy for the woman who
exhibits estrogen deficiency. This phil-
osophV represents the thinking of the
majority of medical writers.
In this article the indications for
and methods of estrogen administra-
38 THE CANADIAN NURSE
Estrogen and the
menopause
Estrog('ns are by no means a panacea for all the problems of aging in women.
They must be used knowledgeably and not simply as a tonic.
Jean Blanchet, B.A., M.D., F.R.C.S. (C)
,
")
Dr. Blanchet is on the obstetrical and gyne-
cological service of The Montreal General
Hospital.
tion will be discussed and, by out-
lining the various precautions and
contraindications involved, it will be
shown why hormonal therapy should
not be used routinely or indefinitely
in all women of menopausal age.
Artificial menopaus('
A distinction must first be drawn
between natural and induced meno-
pause. Young women who have un-
dergone bilateral oophorectomies or
radiation castration necessarily re-
quire special consideration. Compen-
satory estrogen therapy is definitely in-
dicated to offset the sudden and almost
total suppression of estrogen forma-
tion by the body, and subsequent
premature aging.
Natural menopause
The menopausal phenomenon oc-
curring as an outcome of natural ova-
rian failure shows considerable varia-
tion from one woman to another. Vagi-
nal smears taken several years after on-
set show only minor estrogen deficiency
in most women examined. Medical
writers are in general agreement that
only 15 to 25 percent of menopausal
patients have symptoms that warrant
hormonal therapy. In actual fact, only
the hot flushes experienced by the
climacteric woman are directly due to
hormonal deficiency. Other symptoms
such as depression, anxiety, and in-
somnia are temporary manifestations
of psychological problems. The me-
nopause is essentially a physiological
process which is only occasionally as-
sociated with a hormonal deficiency.
Compensatory therapy is indicated
only for those women who show mark-
ed symptoms of this deficiency.
Diagnosis
The estrogen-deficient menopausal
patient is easily recognized by a his-
tory of hot flushes, night sweats, leu-
corrhea, bloody vaginal discharge, as
the result of a vaginitis or atrophic
cervicitis. Cytology results confirm the
suspicion with the finding of a low
percentage of cornified cells. The
atrophic vaginal mucosa shows an
FEBRUARY 1967
abundance of immature and parabasal
cells. Cytology has become part of
routine examination. It is easily per-
formed and can be carried out as
readily in the doctor's office as in
the laboratory.
Clinical signs
Laboratory and clinical findings de-
monstrate the result of hypoestrinism.
There is atrophy of the secondary
sexual characteristics and of the sexual
organs, with senile vaginitis. Excessive
activity of the anterior hypophysis is
manifested by hot flushes and night
sweats. Metabolic changes occur with
associated hypercholesterolemia, athe-
rosclerosis and hypertension. Osteo-
porosis may develop as well.
Hormonal therapy
Women who experience acute, in-
tractable vasomotor disorders that do
not respond to symptomatic therapy
are candidates for estrogen therapy
until their symptoms disappear. Osteo-
porosis and atherosclerosis are the two
conditions to be feared in those pa-
tients suffering from acute estrogen
deficiency either at the time of the
menopause or later. Osteoporosis of
the spinal column may appear as late
as five years after the onset of the
menopause. Backache is the usual
complaint characterizing this condition
although spontaneous fractures may
occur as the process continues. Radio-
logical examination is necessary to
confirm the presence of osteoporosis.
Hormonal therapy can slow down and
even prevent further degenerative
changes while the patient's energy,
strength and general sense of well-
being are augmented.
Atherosclerosis, with its attendant
threat of myocardial infarction and
hypertension, most commonly affects
males rather than young women. How-
ever, the incidence tends to become
the same for both sexes after the age
of 60 if the woman shows signs and
symptoms of hypoestrinism. About 20
to 25 percent of patients require com-
pensatory hormonal therapy. Cyclical
administration of estrogens has a
preventive function in this instance.
Estrogens should be administered
cyclically, simulating the physiological
release of hormone by the body - for
example, three weeks' administration
followed by one week's rest. This
pattern avoids continual stimulation of
the endometrium with its attendant
dangers: hyperplasia and neoplasia.
The smallest effective dose is the
maximum dose that should be used.
Duration of treatment is governed
by clinical response and evidence of
maturation of the vaginal tract. Theo-
retically a patient can be treated in-
FEBRUARY 1967
definitely but as a general rule this is
unnecessary.
Complications
Estrogen administration, especially
in. synthetic form, is accompanied by
nausea and vomiting in a certain
number of patients. A weaker dose
or the use of natural estrogens fre-
quently overcomes the difficulty. The
main problem for the woman with
an intact uterus is vaginal bleeding.
Investigation to rule out the possibility
of organic etiology is indicated, other-
wise a decrease in the dosage of es-
trogen or the addition of androgens
frequently eliminates this complication.
Such bleeding is always a source of
anxiety and should never be treated
lightly.
Contraindications
A careful assessment of the patient's
physical state should precede the de-
cision to prescribe estrogen therapy.
A past history of breast cancer or
cancer of the genital tract precludes
estrogen administration. The presence
of carcinogens in this hormone has
not been proven but laboratory find-
ings and the clinical effects observed
in relation to breast cancer indicate
the need for extreme caution. Patients
with a history of cardiac failure must
also be excluded from such treatment.
Any patient who complains of menor-
rhagia or metrorrhagia at the time of
or after the menopause should have
complete medical investigation in-
cluding gynecological examination, va-
ginal cytology, and, in many instances,
uterine curettage to rule out the pres-
ence of other disease entities.
Estrogens are contraindicated in
the presence of jaundice or hepatic
dysfunction. Liver function tests are
recommended even in the absence of
overt symptoms. Most doctors hesitate
to prescribe estrogens if the patient
has had thrombo-embolism or is suf-
fering form thrombophlebitis or vari-
cose veins. They exercise great caution
if there is evidence of cardiac or renal
disease, hypertension, epilepsy, or
asthma. The possible effects of hor-
monal administration on calcium and
phosphorus metabolism must not be
overlooked in those patients demons-
trating irregularities in metabolism of
these substances.
The development of severe head-
ache, impaired vision, migraine, di-
plopia, or any other neuro-ophthalmo-
logical condition requires immediate
withdrawal of estrogen therapy. The
same procedure applies if changes in
the visual field, retinal hemorrhage or
papillary edema are detected.
In the case of the diabetic patient,
estrogen therapy may alter insulin
requirements. The woman who has had
an earlier psychiatric problem, par-
ticularly a depressive state, must be
carefully supervised throughout her
course of therapy. Any indication of
recurrence of the psychiatric condition
requires immediate cessation of hor-
monal therapy.
Non-hormonal therapy
About 75 to 80 percent of meno-
pausal women retain an adequate pro-
duction of estrogens as has been
proven by vaginal cytology; either the
ovaries are not totally atrophied or
estrogen production is taken over
by the adrenal glands. Explanation
and reassurance are two of the great-
est aids to these patients with occa-
<;ional recourse to light sedation or
mild doses of tranquilizers.
Conclusion
The successful management of the
menopausal syndrome calls for good
sense, sympathy, and patience. Com-
plete opposition to the use of hor-
monal therapy is as much to be de-
plored as empirical administration to
every menopausal patient. The latter
philosophy seems particularly unjus-
tified when it is remembered that less
than one-quarter of menopausal
women exhibit signs and svmptoms of
hvpoestrinism. The administration of
hormones must be undertaken thought-
fully,
nd carefully supervised as the
foregoin!:( consideration of contraindi-
catiõns to hormonal therapy and the
precautions to be taken has indicated.
o
THE CANADIAN NURSE 39
Drug distribution may be described
as the procedure by which a drug gets
from outside of the hospital to the
inside of the patient, with the primary
object of getting the right drug into
the right patient at the right time.
The total process involves the phy-
sician, the nurse, the pharmacist, and
the patient. The physidan plans the
course of drug therapy and evaluates
its results, the pharmacist dispenses
the required drugs, the nurse adminis-
ters them, and the patient, in most
cases, accepts them with trusting re-
signation. But this statement is an
oversimplification for in the modem
hospital a horde of people are involved
in the execution of any single task.
It has been estimated that more than
20 different people are involved at
one time or another in the procedures
for getting a single dose of a drug
into a patient. 1
The responsibilities of nursing and
pharmacy in the drug distribution pro-
cess have been delineated as adminis-
tration and dispensing respectively.
However, these activities do not take
place in a vacuum; they are interde-
pendent and frequently overlap. Nor
do they always take place in complete
harmony. One administrator has been
driven to write that "many adminis-
trators agreed that if they could get
pharmacy and nursing to cooperate
fully, many other problems would dis-
solve.":! Life should be so simple!
The aim of this paper is to exa-
mine those areas of drug distribution
40 THE CANADIAN NURSE
Nurse and pharmacist
-partners
The mutual responsibilities of pharmacy and nursing in drug distribution.
Jack L. Summers
which are of mutual concern to phal-
macy and nursing, some of the prob-
lems which arise, and some means of
minimizing these problems.
Methods of dispensing
Two basic systems of dispensing
drugs have been in use in hospitals for
many years: the floor stock system and
the individual prescription system.
The Floor Stock System is one in
which all but infrequently used drugs
are stocked on the nursing station.
While this system provides the nurse
with an immediate supply of most
drugs, it is costly in terms of nursing
time, space requirements, and inven-
tory, and it lacks control.
In the J ndividual Prescription Sys-
tem practically all medication orders
are dispensed by a pharmacist in the
form of an individual prescription for
a specific patient. This system pro-
vides a high degree of inventory con-
trol and ensures that the physician's
drug orders have been interpreted by
a pharmacist. But the system requires
a great deal of dispensing time without
a compensating reduction in nursing
time. And unless the system functions
with flawless precision, a most un-
Mr. Summers is Professor of Pharmacy,
University of Saskatchewan. He is also Edi-
tor of The Hospital Phamacist, and until
recently, Assistant Director, University Hos-
pital, Saskatoon. He served on the Com-
mittee on Nursing Education that prepared
the Tucker Report.
likely event, there are delays in the
arrival of medications at the nursing
units. This system was popular when
patients were charged for individual
medications, a situation which still
exists in some hospitals in the United
States.
The system now in use in most Ca-
nadian hospitals is a combination of
the floor stock and individual pres-
cription systems. A limited number of
frequently used drugs, not commonly
considered prescription drugs, are
maintained as floor stocks. These in-
clude analgesics, laxatives, antiseptics,
and intravenous fluids. The remaining
drugs are supplied on an individuàl
prescription basis.
Some interesting work is being done
in the development of more effective
svstems of drug distribution. However,
this work is largely experimental and
at the present time no practical alter-
native to the traditional svstems is
readily applicable to Canadian hos-
pitals.
Drug order cycle
From the time that a drug is
ordered by a physician until it is ad-
ministered to the patient, a sequence
of events takes place which, for the
want of a more descriptive term, shall
be called the drug order cycle. A brief
examination of these events will illus-
trate the involvement of pharmacy and
nursing.
. The physician decides on a
course of drug therapy and orders the
FEBRUARY 1967
drugs to be administered to his pa-
tient. This information is communi-
cated to the nurse and entered in the
patient's record.
. The drug is ordered from phar-
macy. If the drug is maintained as
floor stock, the request to pharmacy
is in the form of periodic requisitions
for floor stock replenishment. If the
drug is not in the ward stock, an in-
dividual prescription order is transmit-
ted to pharmacy. This may involve the
nurse in recopying the physician's
original order.
. When the prescription order is
received in pharmacy, it is interpreted,
and the appropriate drug selected,
packaged, and labeled.
. The completed drug order is re-
turned, hopefully to the floor from
which it originated.
. When the completed drug order
arrives at the nursing station, it is
scheduled for administration according
to the physician's instructions. This
procedure involves checking the ori-
ginal order, storage of the drug, and
the creation of medication tickets.
. At the appointed time, a single
dose of the drug is prepared for ad-
ministration, taken to the right patient,
and administered by the appropriate
route. But the administration of the
drug is not the end of the cycle.
. The nurse observes the effects
of the drug on the patient who may
respond favorably, or adversely, or
not at all. Regardless of its nature, the
response of the patient is of impor-
tance to the physician and is record-
ed and communicated to him.
. At regular intervals the physician
evaluates the effects of the drug the-
rapy and orders that it be continued,
or altered, or discontinued. At this
point the cycle ends and may be re-
peated.
The number of separate events in
the drug order cycle is appalling. With
the possibility of error accompanying
each event and the introduction of
each new person into the interpretation
and transmission of the physician's
order, the wonder is not that there
is an occasional error but that there
FEBRUARY 1967
are not more of them! And in ad-
dition to being subject to errors, this
complex procedure is excessively de-
manding of the time of the nurse
Problem areas
It would be kind to say that the
prevalent systems of drug distribution
are cumbersome. But what are the
alternatives?
Two approaches appear to be open:
Adopt an entirely new system of drug
distribution which will eliminate the
present difficulties, and probably in-
troduce an entirely new set of prob-
lems; and improve the traditional sys-
tems by simplifying procedures and
utilizing better methods of communi-
cation.
It has already been noted that, in
spite of considerable work on new
methods, there seems to be no prac-
tical alternative to the traditional sys-
tems of drug distribution for most
hospitals at this particular moment.
Thus, the most productive approach
for the immediate future appears to
be the modification of existing systems
to reduce the number of steps and
people involved in the process. These
changes should aim at reducing the
possibility of medication errors and
relieving the nurse of as much detail
as possible so that she will have more
time to spend with her patients.
If significant improvements in the
present methods of handling drug
orders are to be effected, a clearer
picture of the problem areas which
are of mutual concern to nursing and
pharmacy is necessary. Let us examine
some of these areas in detail.
Origin and transmission of individual
prescription orders
It is common practice for the phy-
sician's orders to be written in an
order book. Drug orders are then
transcribed by the nurse to individual
prescription forms and transmitted to
pharmacy for dispensing.
While the initiation of the physi-
cian's order directly involves the nurse
and the physician, it is important to
the pharmacist that there be no ambi-
guity about the intention of the phy-
sician. The order should include the
name of the drug, the dosage form,
the dose, the route of administration,
and the duration of therapy. If prob-
lems arise at this stage, the remainder
of the process is an exercise in error
which may harm the patient.
In an attempt to overcome errors
of interpreting drug nomenclature,
some hospitals require the attending
physician to print the name of the drug
in the order book or on a special drug
order sheet. But even when the name
of the drug is perfectly legible, errors
of intent may occur.
Recently a physician intended to
order Placidyl* - a non-barbiturate
sedative - but Flaxedil** - a potent
muscle relaxant used to supplement
general anesthetics - was written in
the order book. The order was ques-
tioned by the pharmacist, checked by
the nurse against the order book, and
the drug sent to the ward. The drug
was subsequently administered to the
patient who developed acute respira-
tory distress. The situation was rec-
tified by the prompt action of the
nursing staff, but it provided an ex-
cellent lesson to both pharmacy and
nursing. The pharmacist should have
been aware of the fact that potent
muscle relaxants are normally used
only in the operating theaters, and the
drug should not have been delivered
without checking with the physician
However, the example is not cited to
be critical of judgments but rather
to illustrate that the intention of the
physician is of mutual concern to the
pharmacist and the nurse.
The practice of transcribing the
physician's original order, usually by
a nurse, to a prescription form for
subsequent transmission to pharmacy
is questionable. It introduces a pos-
sibility of error in transcription, a
source of additional work, and several
more pieces of paper to clog the
machinery of drug distribution.
.Placidyl - registered trade name for Ab-
bott Laboratories brand of ethchlorvynol.
uFlaxedii - registered trade name for
Poulenc Limited brand of gallamine triethi-
odide.
THE CANADIAN NURSE 41
The transmission of drug orders
can be simplified by the use of a du-
plicate drug order that provides a copy
for the nurse and a copy for the phar-
macist which serves as a prescription
requisition. This procedure eliminates
the recopying of drug orders and gives
the pharmacists the physician's original
order for interpretation. Questions re-
garding the order mav be discussed
directly with the physician by the phar-
macist. keeping in mind that nursing
must be informed of any change in
the original order.
A drug order form that appears to
solve many of the problems of trans-
mitting the physician's original order
to pharmacy has been developed and
used by Joseph Brant Memorial Hos-
pitaJ3.
Regardless of the system used for
ordering a drug from pharmacy, the
actual transfer of the order should not
require a nurse, or a member of her
staff, to deliver it to pharmacy. The
pneumatic tube, or other automated
transport device, provides a conven-
ient delivery system. In older hos-
pitals, the use of a routine drug or-
der pick-up service, supplemented by
telephone and pharmacy runner,
should make the use of nursing staff
as messengers an outmoded form of
communication.
Prescription labeling
Dispensing is the role of the phar-
macist. While there is little mutual
concern with this phase of operations,
the labeling of the prescription is of
some importance to the nurse. The
label should provide her with suffi-
cient information to get the right drug
into the right patient. In hospitals, it
is customary to label the prescription
with the name and location of the
patient, the name of the prescribing
physician, and the name and strength
of the drug. Directions are omitted
unless specificalIy requested because
the nurse has a number of orders.
card files, medication tickets, and
other assorted sources of information
that give her the dosage schedule of
the drug order. One more source of
information would but add to the con-
fusion.
42 THE CANADIAN NURSE
The name of the drug which ap-
pears on the label frequently poses a
problem to the nurse. Drug nomen-
clature, being the jungle that it is,
makes it possible to label a drug with
a variety of names, alI of which may
be different from the name by which
the physician ordered the drug. The
nurse is not an expert in drug nomen-
clature and it should not be necessary
for her to search reference works to
verify the fact that the name on the
label is synonymous with that by
which the drug was ordered.
The source of the problem is that,
if a physician orders a drug by its
trade name, and a brand of the drug
other than that calIed for by the trade
name is supplied, the prescription
cannot legally or ethicalIy be labeled
with the brand name specified in the
physician's original order. In such
cases the common name of the drug
should be used to identify the drug
supplied. But when this is done, the
label should also read "Dispensed in
place of (brand name specified by
physician)." Thus the nurse does not
have to guess at the meaning of the
common name nor phone to the phar-
macy to see why Mrs. Jones' order has
not arrived!
It must be emphasized that the dis-
pensing of a brand of drug other than
that specified in the physician's order
may only take place with the approval
of the physician, or under the author-
ity of the Pharmacy and Therapeutic
Committee of the Medical Staff.
.. ...
.
"
Pre!>cription delivery
Once a drug order has been trans-
mitted to pharmacy the nurse should
be relieved of further responsibility
until the drug arrives back on her
ward in time to meet the needs of the
patient. But alI too frequently things
don't happen quite this smoothly and
there is a last minute panic to locate
a drug which has been, or should
have been, ordered some time pre-
viously.
Drug orders arrive at the pharmacy
like bananas - in bunches - and the
pharmacist must attempt to place a
realistic priority on their completion.
Some means of indicating emergency
orders for immediate return to the
ward should be worked out between
pharmacy and nursing. "Stat" orders
should not be abused to expedite the
delivery of non-urgent drug require-
ments.
The mechanics of delivering drug
orders to the wards are unimportant
providing that they are convenient for
both nursing and pharmacy, and get
the drugs to the ward in time for ad-
ministration. Delivery may be achieved
by pneumatic tube, or some automatic
conveyor system, by a routine delivery
service, or pharmacy runner, or a
combination of methods. But the me-
thod should meet the requirements of
the particular hospital and deliver the
goods - on time. It is the responsi-
bility of the pharmacist to ensure that
it does so!
FEBRUARY 1967
After-hour pharmacy service
While most of the problems of mu-
tual concern to pharmacy and nursing
arise in the course of the drug order
cycle, several additional areas con-
tribute their share of headaches. After-
hour pharmacy service is a fairly con-
sistent source of distress.
The pharmacy department is open
and fully staffed for a definite period
of time each day. On weekends and
holidays a reduced staff is usually
present at certain times to provide for
the immediate requirements of the pa-
tient.
The hours of operation of the phar-
macy should reflect the demands for
service. More than 90 percent of new
drug orders originate between the
hours of 8:00 A. M. and 5:00 P. M.
Monday to Friday, and this factor de-
termines the hours of full operation.
However. in some hospitals the medi-
cal staff make rounds in the early
evening after office hours. This prac-
tice creates a number of new drug or-
ders and it is reasonable to e;pect
pharmacy to provide service over this
period.
But, illness in general, and emergen-
cies in particular, have refused to ob-
serve the sanctity of the 40-hour week,
and hospitals are required to function
24 hours a day for seven days each
week. Drugs are required after the
pharmacy is closed for the day and
there must be some procedure for ob-
taining adequate pharmacy service
after regular hours.
The aim of after-hour pharmacy ser-
vice is to provide the nurse with those
drugs that are necessary to meet the
immediate requirements of the patient
without undue inconvenience to the
nursing staff. Under no circumstances
shoull the nurse be required to engage
in dispensing. The system should en-
sure that a pharmacist is always avail-
able to discuss medication problems
with the nurse, and to return to the
hospital if the occasion demands.
The ideal solution to after-hour ser-
vice is to have the pharmacy open
for 24 hours a day. For some lafJ.!er
hospitals this approach is a sensible
solution; for some it is a necessity!
However, for most hospitals, 24-hour
operation of the pharmacy department
FEBRUARY 1967
is neither practical nor necessary. But
the responsibility for 24-hour phar-
macy service must rest with the phar-
macist and it is his task to come up
with a suitable answer to his own par-
ticular situation.
The use of an emergency drug sup-
ply for after-hour drug requirements
is a common practice. The nurse, or
more specifically the evening or night
supervisor, is expected to go to the
supply, select the right package, and
leave a requisition for what she has
taken.
While this system does meet a need
- the need for drugs in an emergency
- it is time-consuming and cumber-
some for the nurse. Indeed, it is diffi-
cult to consider it as a service. The
emergency drug system is much too
often used as a substitute for adequate
pharmacy service.
Most medium-sized hospitals require
something between full-time pharmacy
service and the night supervisor as-
suming full responsibility for the dis-
pensing of after-hour drugs. There are
many ways in which the required ser-
vices can be provided, short of 24-
hour pharmacy staffing. The extension
of pharmacy hours on a reduced staff
basis to cover busy evening periods
and weekends, a pharmacist on call,
utilization of retail pharmacists, and
conveniently located pre-packaged
emergency drug supplies may all con-
tribute part of the solution. A combi-
nation of these methods should pro-
vide a satisfactory after-hour pharma-
cy service for most hospitals. But the
degree of service required by a hos-
pital after hours, and the adequacy of
the measures for providing it, should
be arrived at by consultation between
pharmacy and nursing.
Ward stock medications
The pharmacist is responsible for
all drugs in the hospital, regardless of
their location. This includes drugs
maintained as ward stocks.
There are two areas of mutual con-
cern to the nurse and the pharmacist
relative to ward stocks. The first is
the list of drugs to be kept on wards
and the second is the procedure for
replenishing stocks of these drugs.
The purpose of ward stocks is to
provide the nurse with a convenient
supply of most items used in routine
performance of nursing care. Require-
ments for ward medication should be
maintained without a complicated re-
quisitioning and accounting system
and without the nurse being required
to move from the \\'ard to obtain sup-
plies.
The selection of drugs for each ward
should be worked o
t between the
pharmacist and the head nurse of the
particular ward because requirements
vary from ward to ward. While the
nurse may prefer to have all of her
drug requirements readily at hand.
there is some limit, short of the entire
dispensary inventory, that must be
accepted as reasonable. Floor stocks
should not be considered as an inflex-
ible list of drugs but rather a group
of drugs that may be augmented or re-
duced to meet current fashion of drug
therapy and the type of patient on th
ward.
Expensive drugs that may be readily
consumed by other than patients. such
as antibiotics, should not be requested
as ward stocks. Large ward stocks
require an increased inventory which
defeats the purpose of central drug
control, and, indeed, add to the con-
fusion of preparing medications for
patients.
To reorder ward stocks, the most
that should be required of the nurse
is to check off a preprinted form. The
responsibility for picking up orders and
delivering the drugs to the ward at
a convenient time rests with the phar-
macist.
Some hospitals no longer use ward
stock requisitions. The pharmacist
brings the drugs to the wards, checks
the existing supplies, and brings them
up to a scale of issue previously agreed
upon with the staff of the nursing
unit. A modification of this system is
a mobile ward stock unit which is
wheeled up to the ward to replace the
old unit which is taken back to the
pharmacy for replenishment. 4
Narcotic control
The responsibility for accounting
for narcotics and "controlled" drugs
falls upon both the pharmacist and the
nurse.
THE CANADIAN NURSE 43
While the law is quite specific as to
what must be done, pharmacy and
nursing can work together to develop
procedures which fulfill both the letter
and the spirit of the regulations with-
out creating too great an inconve-
nience to either profession.
Requisitioning procedures should
require only the signature of the head
nurse or her deputy. The requested
narcotics and controlled drugs may
then be delivered to the ward at a
convenient time each day. Nursing
units should stock adequate supplies
of narcotics and controlled drugs and
should not be required to return an
empty container before being allowed
to reorder a second. This makes it
possible for the nurse to plan her nar-
cotic orders on the basis of a 24-hour
requirement and prevents needless
trips and requisitions by both pharma-
cy and the nursing unit.
It should not be necessary for the
nurse to return the completed record
of administration to the pharmacy per-
sonally unless some problem has ari-
sen. Under normal circumstances, it
should be sufficient for both records
and containers to be picked up by
pharmacy when narcotics are deli-
vered, or sent back with the normal
drug returns.
A shift count of narcotics is some-
times required by nursing service. The
merits of this particular form of enter-
tainment will not be debated at this
point. But where such a procedure is
required, it is helpful if narcotics are
packaged in such a manner that indi-
vidual doses can be seen and counted
without removing them from the con-
tainer. This prevents wear and tear on
both narcotics and nursing tempers.
Many such containers are now availa-
ble and there is no valid reason for
not putting them to use.
Nursing may greatly assist in the
control of these drugs bv bringing
problems to the attention of the phar-
macist as soon as they are suspected.
Narcotics that have not been used for
some time should be returned to the
dispensary rather than left on the ward
for daily counting.
Developments in drug distribution
It is becoming increasingly obvious
44 THE CANADIAN NURSE
that the traditional methods of drug
distribution are no longer adequate
to meet the requirements of the mod-
ern hospital. The most significant
reasons are said to be:
I. The high percentage of medica-
tion errors reported in the literature
and
2. the widespread shortage of per-
sonnel, especially nurses. ã
Work is being done on the develop-
ment of several new systems of drug
distribution, most of which are based
on the unit-dose system of dispensing.
In this system, all drugs are delivered
to the floor in single doses, labeled
for specific patients, and ready for
administration, immediately prior to
the time at which they are to be ad-
ministered to the patient. All that is
required of the nurse is to take the
prepared medication to the right pa-
tient and administer it.
The successful introduction of such
a system will require considerable
mental and mechanical adjustment on
the part of both nursing and pharma-
cy. But regardless of the problems in-
volved, few should quarrel with the
object of the system, which is to re-
lieve the nurse of many of the time-
consuming mechanical details which
now keep her from the patient. It
should also contribute to a reduction
of the volume of waste paper which
now accumulates in the nursing sta-
tion. 1I
Automated dispensing units of the
vending machine type have been intro-
duced in an attempt to improve drug
distribution techniques. While this de-
vice does have some very desirable
features, it does little to improve the
lot of the nurse. Indeed, this type of
equipment is now obsolescent in the
light of newer developments.
Some of the more sophisticated ad-
vanced systems incorporate the utiliza-
tion of automatic data processing
and telecommunications. Not only
does the system deliver the required
drugs in unit doses, but sends a mes-
sage reminding the nurse that medica-
tion is due for certain patients whose
names are printed out. The machine
calls back in 15 minutes to ask if the
task has been completed. 7
One of the new developments al-
lows the physician to select and or-
der his drug therapy on a device si-
milar to a television screen. One gets
the impression that the nursing station
in the automated hospital will resemble
a fire control unit of a nuclear bat-
tleship.
Many of the experimental systems
being tested at the present time will be
applicable only to specialized hospi-
tals. But out of the present work will
evolve a new system, or systems,
which will be applicable to all hospi-
tals, and which will solve many of the
problems which beset both pharmacy
and nursing in the process of drug
distribution.
Until new systems are developed,
there is much that can be done to im-
prove the present methods of providing
drugs for patients. But to do so will
require a genuine effort on the part
of nurses and pharmacists to become
familiar with their areas of mutual
responsibilitv and to minimize the
causes of friction which are irritating
to ourselves and detrimental to the
welfare of our patients.
But regardless of the development
of new systems, the introduction of
automation, and the use of automatic
data processing, the pharmacist will
not provide the nurse with the assis-
tance which she requires, and which
he is capable of providing, until he
moves out of the dispensary to where
the action is - on the wards of the
hospital. The shiny new tools and
gadgets, from which so much is ex-
pected, must be looked upon as a
means of helping to achieve this aim.
References
J. Latiolais, C.J. Hosp. Manag. 94: 80.
Sept. 1964.
2. Biggs, E. L. The Administrator-Pharma-
cist Relatiornhip. Canad. Hosp. 43: 44,
June 1966.
3. Smythe, H.A. Hosp. Pharm. 19: 103.
May-June 1966.
4. Victorine. Sister M. Amer. J. Hosp.
Pharm. 15: 973, Nov. 1958.
5. Stauffer. I.E. Hosp. Pharm. 19: 149.
July-Aug. 1966.
6. Barker, K.N. and Heller, W.M. Amer.
J. Hosp. Pharm. 20: 568, Nov. 1963.
7. Jang, R. and Barker, K.N. Mod. Hosp.
p. 124, April 1965. 0
FEBRUARY 1967
Tumors of the skin are very com-
mon, usually occurring on exposed
surfaces such as the face or the back
of the hands, but can appear anywhere,
particularly if the site is subject to
persistent trauma. Exposure to wind,
sun, and frost are etiological factors,
and skin tumors are more common in
the white populations living in tro-
pical climates and in persons such as
farmers or fishermen who work outside.
Tumors may be benign or malig-
nant, are often multiple, and seen more
frequently in the older age groups.
Some benign lesions become malignant
with time, and, although most malig-
nant tumors arise primarily in the skin,
occasionally they are a manifestation
of widespread cancer. Metastases from
breast and lung tumors are the com-
monest and the malignant lymphomata
can infiltrate the skin.
Skin cancer usually implies tumors
of epithelial origin and may be clas-
sified according to histological charac-
ters. They are generally of low-grade
malignancy and the majority are cured
at the first attempt. Where the first
The author expresses his appreciation to
Mrs. M. Gaettens of the Department of
Medicine Photography, The Princess Mar-
garet Hospital, for providing the clinical
photographs, and to Mrs. M. McIntyre for
her secretarial and typing services.
Dr. Fitzpatrick is radiotherapist at The
Princess Margaret Hospital. Toronto. On-
tario.
FEBRUARY 1967
Tumors of the skin
A brief description of the benign and malignant tumors of the skin,
and their treatment.
P.J. Fitzpatrick, M.B., D.M.R.T., F.F.R.
planned treatment fails to cure the pa-
tient, secondary measures are usually
effective and few patients succomb to
this disease.
Benign tumors
These lesions tend to have a long
history. They "sit on" the skin rather
than invade it, are frequently pigment-
ed and multiple, involving large areas.
The commonest is the hyperkeratosis
(Figure 1) which presents as a rough-
ened area of thickened skin and may
show ulceration; in time, these may
develop into squamous cell carcino-
mas. Bowen's disease is intraepithe-
Iial carcinoma that tends to occur at
mucocutaneous junctions, particularly
around the anus and the lip; these le-
sions, too, sometimes progress to frank
squamous cell cancer. The keratoacan-
thoma (Figure 2) is an interesting
tumor that is often misdiagnosed for
the more serious epithelioma. The
history is short, often of only a few
weeks duration, with rapid growth
commencing as a pimple that breaks
down in the center to show a keratin
plug. On separation this leaves an ul-
cerated, indurated base; left to itself,
spontaneous healing will occur with
an average life of 12 to 25 weeks
(Figure 3). Other benign tumors are
mentioned for completeness but are
outside the scope of this article (Figures
4, 5, 6).
Malignant tumors
Basal Cell Carcinoma
The rodent ulcer is the commonest
malignant tumor of the skin. Its site
of election is the face above a line
joining the lobe of the ear to the angle
of the mouth, particularly at embryo-
logical junctional areas. The tumor
erodes away at tissues, but does not
Common Primary Skin Tumors
BENIGN MALIGNANT
Keratosis Basal Cell Carcinoma
Wart (Rodent Ulcer)
Angioma Squamous Cell Carcinoma
Keloid (Epithelioma)
Nevus (Mole) Malignant Melanoma
Keratoacanthoma Bowen's Disease
THE CANADIAN NURSE 45
metastasize and usually is not a serious
condition, although large tumors can
produce hideous deformities. It starts
as a small lump that breaks down in
the center and refuses to heal. Growth
is slow and the edges of the tumor
are pearly white in appearance with
numerous small blood vessels present.
Squamous Cell Carcinoma
Epithelioma frequently arises in as-
sociation with other skin changes due
to climatic exposure or trauma. It is
therefore more common on exposed
parts of the body and grows directly
by extension into the surrounding tis-
sues, sometimes metastasizing to the
regional lymph nodes. It starts as a
pimple or ulcer that will not heal and
growth may be rapid. The edges of
the ulcer are raised, rolled, and everted
and the base bleeds easily (Figures
7, 8, 9, 10).
Malignant Melanoma
This tumor is less common than the
epithelioma and may occur anywhere
on the skin, most commonly around
the orbit or on the limbs. It has a
sinister reputation because of its black
color and its tendency to re::ur locally
Fig. 1: Seborrhea keratosis on the left
cheek of a 66-year-old farmer. It was
present for 2 years, growing slowly,
and bleeding at touch. Treated with
single shot of irradiation.
Fig. 4: Keloid scar on the back of lobe
of an ear following piercing. No
treatment given.
46 THE CANADIAN NURSE
if inadequately treated. There is a high
incidence of metastases that may ap-
pear as satellite nodules around the
primary tumor (Figure 1/) or spread
through the lymphatics to the regional
nodes. Involvement of other organs,
particularly the lungs and liver due to
bloodstream spread, is common. The
tumor is not always pigmented and it
may follow change in a benign nevus;
occasionally there is a history of rapid
growth or bleeding associated with
pregnancy. This tumor carries the
worst prognosis of any skin tumor.
Patient management
At The Princess Margaret Hospital.
patients are seen in a special skin clinic
where a history is taken' and clinical
examination carried out. Following
this a diagnosis is made which is usual':
Iy followed by a biopsy to confirm the
clinical impression. A photograph is
useful in following the subsequent
progress of the tumor and occasionally
x-rays are required to see whether
there is any bone destruction or to
search for the presence of metastases.
Irradiation has been used in the
Fig. 2: Keratoacanthoma on nose of a
57-year-old man. Present for 6 weeks.
growing rapidly. but not bleeding,
Treated with simple curettage.
Fig. 5: Angioma on the head of a
2-month-old baby. Tumor disappeared
spontaneously without treatment over
a 3-year period.
{I
treatment of skin tumors for over 60
years. The therapeutic use of radiation
depends on its ability to destroy se-
lectively abnormal tissue without dam-
aging the adjacent normal structures.
This is accomplished by various treat-
ment techniques and the physical pro-
perties can be adapted to suit any
tumor and site. Many techniques have
been used and the radiation obtained
from radioactive isotopes or x-ray ma-
chines. Radium has been the isotope
used most extensively and is still used
in the form of needles that can be im-
planted into the tumor, or as a sur-
face applicator; however, these now
have been replaced for the most part
by external irradiation from an x-ray
machine.
Radio-isotopes emit radiation of dif-
ferent types by disintegration of the
nucleus, the gamma ray being used for
therapeutic effect. These rays are simi-
lar to x-rays and related to those of
light, heat and radio, but are of ex-
tremely short wave lengths. Radiation
is absorbed in tissues and its depth
of penetration depends on several fac-
tors. In general, the higher the voltage
.
Fig. 3: Same patient as in Figure 2,
four months later.
Fig. 6: Benign papilloma in the left ear
of a 72 - year-old man. Present most of
his life but recent bleeding due to
trauma. Tumor removed by curettage.
.. ')
...
,
FEBRUARY 1967
the greater the depth dose achieved.
Thus, at 100 KV, the useful depth of
irradiation is about 4 mm.; deeper
tumors have to be treated with more
powerful units.
Rodent ulcers and epitheliomas are
moderately radiosensitive and can be
readily destroyed by radiation. If the
tumor is small, a single treatment will
suffice and is useful in treating {)1d
people, especially if they have had to
travel from afar. Larger tumors have
to be treated over several days to get
a cancericidal dose that will not dam-
age the normal surrounding structures.
A better cosmetic effect is obtained
and the chances of getting a geogra-
phic miss, possible with a single shot
treatment, eliminated.
Most tumors are superficial and low
voltage x-ray machines operating at
less than 100 KV provide effective
treatment. For thicker lesions a higher
voltage at 250 KV is required. Today,
high energy electrons and other radio-
active isotopes, such as Caesium 137.
increase our therapeutic armory.
Following irradiation, the tumor
develops an erythema and subsequent-
Fig. 7: Epithelioma on left hand of
a 49-year-old laborer. Present for 8
months and growing rapidly. Treated
with rodium nwld.
Fig. 10: Same patient as in Figure 9.
Result shown 18 months later.
FEBRUARY 1967
ly becomes covered with a ycllow fi-
brinous exudate; this reaches its maxi-
mum intensity after about two to three
weeks and becomes slightly sore.
Crusting follows. On separation four
to six weeks following therapy, the
.tumor is found to have disappeared,
although complete resolution some-
times takes a little longer. The cosme-
tic result is usually good and repre-
sented by minor atrophy of the skin.
although telangiectasia may occur after
treatment of large tumors many years
later. Recurrence is uncommon and
probably best treated by excision be-
cause of the danger of necrosis fol-
lowing heavy irradiation. The latter
follows damage to the blood vessels
of the skin which develop an endarte-
ritis with subsequent deficient nourish-
ment and oxygenation of the involved
area.
Unfortunately the malignant melano-
ma is not a radiosensitive tumor, al-
though small ones can be destroyed by
heavy irradiation. These tumors are
best excised and it is generally accept-
ed that any excision that does not re-
quire skin grafting is inadequate. Irra-
diation is used to supplement surgery
.....
i\
Fig. 8: Same patient as in Figure 7.
Result shown 4 years later.
Fig. 11: Malignant melanoma on left
foot of a 67-year-old man. Present for
many years. Tumor excised and
grafted, but patient died of distant
metastases three years later.
where the latter may have been in-
complete, and is useful in palliating
the symptoms of advanced disease.
The techniques used at The Princess
Margaret Hospital and the common
reactions encountered and their man-
agement will be described in the fol-
lowing article. After treatment, skin
tumors are followed in the outpatients'
clinic to assess the result 0
-
..
p.
"
Fig. 9: Epithelioma lower lip present
for 6 months. Treated with external
irradiation.
THE CANADIAN NURSE 47
During the past eight years, one out
of every five new patients registered
at The Princess Margaret Hospital in
Toronto had some form of skin cancer;
in fact, nearly 5,000 new patients were
seen and treated.
Most patients are treated on an out-
patient basis; very few need to be ad-
mitted to hospital. If patients come
from outside the city, they can be
accommodated in The Princess Mar-
garet Lodge, which is situated about
100 yards from the main hospital.
Room and meals are provided at the
Lodge, but the patient is able to go out
and follow whatever pursuits he likes.
The skin clinic in the outpatients'
department is staffed by a consultant
dermatologist and radiotherapist. They
examine each patient, make a diag-
nosis, and prescribe treatment. The
patient is then escorted by a volunteer
to the radiotherapy department and
introduced to the radiographer who ex-
plains the course to be followed.
Description of department
The radiotherapy department is de-
signed to make treatments as efficient
and pleasant as possible. Radiation
used therapeutically produces no haz-
ard to the patient; but irradiation in
small doses received over a long period
of time by personnel working in the
therapy departments is hazardous. Cer-
tain precautions are taken to mini-
mize exposure. The walls of the treat-
ment room are of thick concrete and
the observation windows contain lead
48 THE CANADIAN NURSE
Radiation therapy for
skin cancer
Minimizing the patient's fear about the diagnosis of cancer and the method of
treatment is a major responsibility of the radiotherapy technician.
Doris Martyn, Reg. N., R.T.
so that no stray radiation can filter
to the outside. Because of the dangers
of radiation exposure, the technician
is not allowed to be in the room at
the same time as the patient while
treatment is being carried out, but ob-
serves him through the specially pro-
tected window.
The treatment rooms are pleasantly
decorated and spacious to prevent
claustrophobia. As there are no out-
side windows, murals of outdoor scenes
cover one wall. A two-way communi-
cation system has been set up so that
technician and patient can converse at
all times while therapy is in progress.
To encourage relaxation, soft back-
ground music is piped into all treat-
ment rooms.
Radiotherapy
The doctor prescribes the amount
and type of radiation required and
specifies the area to be treated. This
varies according to the nature of the
tumor and its extent. The prescription
is written on a special treatment sheet,
and unless the treatment is compli-
cated or extends for more than five
days, the doctor will not see the pa-
tient again until the first follow-up
visit in the outpatient clinic. The radio-
grapher is now responsible for the
planned treatment and for establishing
rapport with the patient.
Miss Martyn is Senior Radiotherapy Tech-
nician at The Princess Margaret Hospital.
Toronto, Ontario.
When external irradiation is to be
used, the patient is placed on a treat-
ment couch with the appropriate area
exposed. Treatment for each patient
is individualized. The regular set of
applicators are suitable for a good
proportion of the patients, but some
situations require special shields that
can be made to any size or shape.
Most skin cancers are treated with
superficial x-ray at 100 kilovolt. A
very thin sheet of lead (0.5 millimeters
thick), which can be cut with scissors,
prevents any radiation from passing
through it. Large tumors are treated
at a moderate voltage and the shield-
ing has to be thicker to prevent irra-
diation of the surrounding normal tis-
sues. The doctor will have marked the
area to be treated with a skin pencil.
This is then outlined with the appli-
cator or lead cut-out and the x-ray
machine is placed in position. Patients
who are comfortable will maintain
their position better than those who
are not, and if there is any danger of
movement the part to be treated is
supported by sand bags.
The patient is told again that the
treatment is painless but that there
will be a whirring sound from the ma-
chine which is quite normal and no
cause for alarm. The technician re-
treats from the room, shuts the door,
calculates the treatment time, and
turns on the radiation beam. Most
treatments take only a few minutes.
When the prescribed dose has been
given, the machine automatically turns
FEBRUARY 1967
-.--..
=
o
.-
itself off and the technician re-enters
the room, releases the x-ray applicator,
and removes any shields.
Protection badges worn
To make sure that nurses and tech-
nicians do not receive irradiation
beyond the maximum permissible level
as outlined by the World Health Or-
ganization, protection badges are worn
and blood counts taken periodically.
The protection badge consists of a
small x-ray film, which is sensitive to
radiation. The badge is worn on the
chest of the technician and any ex-
posure of radiation can be determined
by the subsequent development of the
film.
Treatment of rodent ulcers
Rodent ulcers around the eyelids
are common. At this site special lead
shields have to be placed inside the
lids to protect the underlying eye
(Figures 1, 2, 3, 4). The shields are
made out of lead with the concave con-
junctival surface coated with a thin
layer of plastic. Several sizes and
shapes are available and one is select-
ed to suit the patient. They are stored
dry, but prior to use are soaked in
1:750 solution of aqueous zephiran for
half an hour and then rinsed in sterile
water for five minutes.
To anesthetize the eye we use 0.5
percent pontocaine; two drops are
placed in the lower conjunctival sac
and repeated after five minutes. Five
minutes later, the eye shield, lubri-
FEBRUARY 1967
Fig. 1: A 52-year-old man with ulcer
below the left .eye. The ulcer had been
present for 1 year, was growing slowly,
and bleeding on occasion. Biopsy
confirmed the present of a rodent ulcer.
Fig. 2: Same patient showing the area
to be irradiated marked out and an
internal eye shield in position.
cated with mineral oil, can be inserted
by slipping it under the lower eyelid
and lifting the upper eyelid over it.
After treatment the shield is removed
and 10 percent sulphacetamide drops
are instilled into the lower fornix to
prevent subsequent infection, together
with one or two drops of mineral oil
to minimize irritation. A pad and ban-
dage are applied until sensation has
returned which usually occurs within
one to two hours. Without the pro-
tective bandage, a piece of grit could
lodge in the eye and produce damage
without the patient being aware of it.
If a single treatment has been pre-
scribed, the nature of the subsequent
reaction is explained to the patient.
If further treatments are planned, a
return appointment is arranged to fit
in with the patient's other commit-
ments, so as to disturb his normal
routine as little as possible.
Skin reactions to irradiation
Within a day or two of being irra-
diated, the treated skin shows a faint
erythema which increases over several
days. This reaches a maximum inten-
sity after about 10 days, and a moist
desquamation of the skin often occurs
at this time. During this period, trauma
to the treated area should be avoided
and the affected skin kept dry. If dis-
comfort occurs, Nivea Creme or lano-
lin should be applied sparingly two
or three times a day. If the reaction
is unduly severe, as sometimes occurs
in persons with fair or sensitive skin,
...
..;
one percent gentian violet solution ap-
plied two of three times a day will
produce a scab and allow the under-
lying tissues to heal.
Following moist desquamation, crusts
appear; these are best left to separate
on their own. Separation usually oc-
curs between the third and fourth
weeks and a new pinkish skin is seen.
The tumor will often have disappeared
by this time, but sometimes a residuum
is left. Further disappearance occurs
during the next few weeks with no
special treatment required apart from
avoidance of trauma.
The patient should be protected
from sunlight, wind, and frost, since
these can cause severe local reactions,
manifested by redness, soreness, and
weeping of the treated area, with de-
layed healing. Infection, too, must be
avoided or increased scarring will re-
sult with impaired cosmetic result; the
patient is advised against rubbing the
area. If there is hair in the irradiated
area, permanent epilation usually will
result; although this is of little con-
sequence, the patient should be warned
about it.
The doctor examines each patient
about two months following treatment
to assess the result; however, he will
see him before this time if the need
arises. A careful explanation of the
reactions that follow irradiation and
a form that gives the patient general
instructions on management of the
treated area usually make this earlier
visit unnecessary.
THE CANADIAN NURSE 49
------
.
o
...
-'.
so THE CANADIAN NURSE
-
"
'\
-
.,.
Fig. 3: Patient being prepared for
treatment.
II
PICKER
I
,
....
I
"-
Dressings to irradiated areas are
not required unless the patient is ex-
posed to trauma or dirt, in which case
a simple cover minimizes the risk of
infection. Follow-up of these patients
is shared by the local doctor and the
clinic. A patient with a rodent ulcer
can usually be discharged from clinic
follow-up after one year, but is ad-
vised to see his own physician if he
notices any skin changes at the treated
site or elsewhere. Follow-up after one
year is unnecessary if the tumor has
completely disappeared because late
recurrence is rare.
Other malignant tumors are followed
indefinitely because of the possibility
of local recurrence or the appearance
of metastases. Because skin tumors are
frequently multiple, the precipitating
causes are explained to the patient and
he is advised to protect himself as far
as possible.
Fears
Many patients verbalize their fears
and apprehensions to the nurse rather
than to the doctor. Explanations and
reassurance will allay these fears, but
definite answers are needed for ques-
tions, such as "Will it burn?"
During the Second World War,
Norman Rockwell painted four can-
vases entitled "The Four Freedoms."
One of these illustrates a basic need
of all human beings: "Freedom From
Fear." Fear of cancer is perhaps one
of the most terrifying fears today. As
nurses, we face the tremendous chal-
lenge of assisting a patient through the
initial frightening phase following a
diagnosis of cancer. We must try to
give him peace of mind, a sense of
security, assurance and hope. These
things we have been trained to do;
but to do it properly, we need to edu-
cate ourselves in the modern methods
of therapy. 0
Fig. 4: Patient being treated. A lead
cut-out is seen outlining the area to be
irradiated.
FEBRUARY 1967
books
Fundamentals of Public Health Nursing
by Kathleen M. Leahy, R.N., M.S. and
M. Marguerite Cobb, R.N., M.N. 225
pages. Toronto, McGraw-Hill Book Com-
pany, 1966.
Re\'iewed by Miss Margaret Steed, nursing
consultant, education, Canadian Nurses'
Association, Ottawa, Ontario.
This book was written to provide nursing
students with the necessary guidelines in
preparation for their experience in public
health nursing.
The content was developed specifically
for use in baccalaureate pre-service pro-
grams, designed to prepare nurses for be-
ginning positiorn in public health nursing,
but would be similarly applicable in a di-
ploma program in nursing where public
health concepts are integrated throughout the
nursing courses.
The information in the textbook is pre-
sented in two parts.
Part one is devoted to public health and
public health nursing, the principles of
public health nursing, together with history,
trends and philosophy. Information is given
specific to the home visit, and related to
essential communication skills and statistics.
The identification of the role of the public
health nurse, as it is viewed on the health
team, seems to require an excessive review
of historical material.
In part two, a variety of selected case
situations and case records together with
topics and questions suitable for discussion
periods are offered. This part of the book
adds to the true value of this basic textbook
for nursing students, in that descriptions of
actual situations experienced and problems
encountered by public health nurses are
narrated and designed to provide some
insight into public health nursing and the
skills, understandings, appreciations and
awareness that are required and utilized.
Geriatric Nursing, 4 ed, by Kathleen New-
ton, R.N., M.A. and Helen C. Anderson,
R.N., P.T., M.N. 390 pages. Saint Louis,
Mosby, 1966. Reviewed by Mrs. Valerie
Nicholson, instructor, School of Nursing,
Calgary General Hospital, Calgary, Al-
berta.
Recognizing, firstly, that the word geriatrics
is that "branch of medical and nursing
science that deals with the treatment and
care of disease conditions in older people,
including constructive health practice and
prevention of disease," and formulating,
FEBRUARY 1967
secondly, a philO!>ophy or concept of
geriatrics in keeping with this - old age
can be satisfying and need not be a period
of idle sitting and waiting for the inevitable,
death - the authors have organized the
fourth edition of Geriatric Nursing into four
major units. These include an introduction
to the aged, and a description of health
maintenance and illness prevention, the gen-
eral factors in the care of the ill, and clinical
nursing.
Unit one emphasizes the attitudes and
personal qualities essential to the nurse who
deals with older people. Basic to the nurse's
approach is a knowledge of the socio-psy-
chological needs of the aged - "the need
for somewhere to live, something to do, and
someone to care" - and a thorough under-
standing of why these basic needs are
not met in our society. Related to the prob-
lems of the aged is society's rejection of
old people and its emphasis on youth and
beauty. The authors state that the prob-
lem, paradoxically, seems to be one of
preserving the life of the older person on the
one hand, while killing him socially on the
other.
Unit two discusses maintenance of health
and prevention of illness. Physical care for
the aged differs from that for younger per-
sons. Adjustments, small in themselves, may
mean the difference between the comfort and
well-being of the older person and his dis-
comfort and predisposition to disease. To
illustrate, the authors present the adjustments
necessary for each basic physical need, i.e.,
bathing, skin care, sleep, ventilation, rest,
activity, posture. clothing, diet. elimination
and safety; throughout, a general regard for
the older person is interwoven. emphasizing
the importance of psychological needs. More
pictures of older people in their homes,
rather than in hospital beds, would have
been useful in this section.
The authors stress the nurse's strategic
position in teaching people of the impor-
tance of periodic health appraisals and of
available community services. Far. too often
elderly persons and their family members
interpret nornpecific symptoms as the inevit-
able concomitants of advancing age.
Unit three, dealing with general factors
in the care of the iU, discusses housing
during illness, rehabilitation. and specific
treatments such as physical and occupational
therapy. The home is suggested as the best
place for the elderly patient except in the
event of acute illness or intensive treatment
of chronic illness. Home care programs and
instruction for family members are included
in the nurse's role. "Repersonalization," or
the restoration of a sense of personal worth,
must preceed successful rehabili1ation.
The final unit, more tllan half of the
entire book, deals with nursing the elder-
ly person with diseases and is arranged
according to body systems. Since the clinical
approach to many of the disease conditions
is the same for the elderly as for the
younger person, this book specifically men-
tions only those that pertain to the care of
the older person.
This book would be a valuable reference
book in any school of nursing library be-
cause of its detailed, thoughtful, and in-
dividualized approach to the care of older
people in our society.
Psychiatry for Nurses by John Gibson,
M.D., D.P.M. 1S6 pages. Oxford. Black-
well Scientific Publications, 1966.
Reviewed by Mrs. Doris DesMarteau,
acting assistant director of nursing, The
Ontario Hospital, Cobourg, Ontario.
This book introduces the general duty
nurse to psychiatry. A welcome addition to
the works on this subject, it would be a
useful teaching manual and handy reference
for all mental health workers. A lucid and
concise account of the psychiatry of child-
hood to old age, it presents a simplified ap-
proach to a complex subject.
In her association with the psychiatrist,
the nurse will constantly hear technical
terms. If she is familiar with them, she can
communicate more intelligently with
members of associated professions, and read
psychiatric literature with increased under-
slianding. With a knowledge of certain group-
ings of personality disturbances, she will
have a broader insight into the nature of
her patient's illness.
In the introduction the author deals with
the scope of psychiatry. He points out that
there is no clear distinction between mental
and physical illness, and that many physical
diseases manifest themselves through mental
symptoms. Mentally ill patients, like the
physically iU, suffer from definite illnesses
that require individual methods of treat-
ment.
Chapter two outlines the signs and symp-
toms of mental illness. Subsequent chapters
deal with neuroses and psychosomatic dis-
orders. Schizophrenia and paranoia are
cornidered in detail as two of the most im-
portant psychoses. Alcoholism and drug ad-
diction are e"plained as social as well as
medical problems. One chapter describes
organic diseases that commonly produce
mental symptoms.
Chapter fourteen defines mental subnor-
mality as a common condition. Mental
THE CANADIAN NURSE 51
books
defectives, a large part of any mental hos-
pital's population. demand their own treat-
ment and training that must be understood
by the nurse.
In the section devoted to psychiatry of
childhood. the author emphasizes the prob-
lems presented by mentally ill children.
which usually differ in certain respects from
psychiatric problems of adults.
In his last chapter "Principles of Treat-
ment", Dr. Gibson describes at length treat-
ments and medications applied to many types
of illnesses. He also mentions some qualities
essential for the nurse who cares for mental
patients.
Knowledge alone does not necessarily
make it easier to tolerate the persistent hos-
tility. rejection. and discouragement that the
nurse often meets, but it does help her to
understand the sufferings of the mentally
ill that can be deep and tragic.
The Human Body, A Survey of
Structure and Function by John
Caimey, C.M.G., D.Sc., M.D., F.R.A.C.S.
and J. Caimey. 8.Sc., M.B., Ch.8..
M.C.R.A. 286 pages. Christchurch, New
Zealand, N.M. Peryer Limited, 1966.
Re
'iewed by Miss lean W. Spaldillg,
associate director of nursing education,
Torolllo East General & Orthopaedic
Hospital.
This text is written in a clear, concise
form that would be most helpful in an intro-
ductory course in anatomy and physiology
for students, who need general information
and clarification of terminology. The dia-
grams are excellent and adequately labeled,
providing good visual aids.
Chapters one to eleven provide the best
content; later chapters, including those on
the muscular, nervous, blood vasular, and
endocrine systems, provide insufficient in-
formation.
To understand body alignment, passive
exercises, etc., the nurse must have a
thorough knowledge of the muscular systems,
which this book does not provide. More-
over, the chapter on the blood vasular sys-
tem presents insufficient physiologic detail
and the chapter on the endocrine system
lacks current information.
The anatomy in this text would be ade-
quate but sufficient physiology is lacking.
The major reason for teaching anatomy and
physiology is to provide a basis for under-
standing health and for providing nursing
care. This text does not include the material
necessary to give the student such a back-
ground. Its value would be enhanced by the
addition of questions at the end of each
chapter for review and application, and a
bibliography for reference.
52 THE CANADIAN NURSE
a show of hands...
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or yours!
ALCOJEL is the economical, modern,
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ensures that it will not run off, drip
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ALCOJEL cools by evaporation . . .
cleans, disinfects and firms the skin.
Your patients will enjoy the
invigorating effect of a body rub with
Alcojel . . . the topical tonic.
r . coo tin
efreshH"\g... 9.
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Send for a free sample
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FEBRUARY 1967
books
Rehabilitative Aspects of Nursing,
Programed Instruction Series. Part I.
Physical Therapeutic Nursing Measures.
Unit I. Concepts and Goals. 51 pages.
New York. National League for Nursing,
1966.
This pTOgramed unit is the first of a
series of progrdmed nursing texts planned
by the National League for Nursing. It
was prepared especially for inservice edu-
cation of nursing staff and for self-instruc-
tion by individual nurses. It is designed to
enable nurses to learn, at their own speed.
new facts and skills in rehabilitative nursing.
This introductory unit is devoted to gen-
eral concepts and goals and to the treatment
of the patient as a whole person. Future
books will deal with range of joint motion,
muscle conditioning. body positioning, and
assessment processes in rehabilitative nursing.
The booklet is easy to use and thoTOughly
o
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covers the introductory aspects of rehabilita-
tive nursing. The time required to complete
all frames is approximately two and one-
half hours.
Much of the material i
extremely simple
and would appear to be more valuable to
students than to graduate nurses. However.
considerable attention is given to aspects of
care that involve diagnosis, assessment, and
establishment of physical therapeutic nursing
measures on the nurse's own initiative, that
is, in her OWn team TOle and without the
supervision of other disciplines.
The book would be a useful addition to
any ward library. Inservice nursing educators
would find it valuable as a supplement and
adjunct to many teaching programs.
History and Trends of Practical Nurs-
ing by DOTOthy F. Johnston, R.N., B.S.,
C.P.H.N., M.Ed. 171 pages. Saint Louis,
Mosby, 1966.
Reviewed by Mrs. P. Ecclestone, acting
instructor, School lor Nursing Assistants,
King Edward VII Memorial Hospital.
Bermuda.
This interesting book outlines the events
that have shaped and brought into existence
the present-day practical nurse or nursing
assistant, as she is known in Canada. Five
of the nine chapters deal with the past, two
with the present, and one with the future
of this auxiliary worker.
The author traces the development of
the practical nurse from the primitive
woman who remained at home caring for
the weak and sick while man foraged for
food, through the religious orders, which
provided rituals and housekeeping services
rather than actual nursing care, to the
beginning of the training of lay women in
the early nineteenth century.
In discussing the early training programs
and the growth and expansion of the profes-
sion, the author gets rather bogged down
in dates and details. The reviewer found
herself flipping pages and reading the con-
cise and comprehensive summaries at the
end of each chapter.
In the chapter "War and Awakening,"
tbe author describes the professional nurse's
realization, after World War II, of tbe need
for the practical nurse in the hospital as
well as in the home. The professional nurse
finally accepted the responsibility for her
control. Many states began passing laws for
her licensure, curricula were expanded, her
title was standardized, and she emerged a
recognized and necessary part of the health
team.
The author discusses todays practical
nurse in the United States and nursing
assistants in Canada in chapters 7 and 8.
Canadian nurses will find Chapter 8 very
interesting, as tbe author describes the
number of schools, admission requirements,
THE CANADIAN NURSE 53
books
length and description of the course, and
number of trained as.
istants employed in
each province.
In her final chapter, "Preview of the
Future," Miss Johnston discusses the areas
in which the practical nurse is now em-
ployed, and conjectures about her future.
In spite of rumblings in some camps to the
effect that the practical nurse faces ex-
tinction with the emergence of a "new
nurse" who is a product of a two to three-
year course in an independent school, the
author believes that the outlook for the
practical nurse is excellent, as thousands
more are needed for employment in general
hospitals, psychiatric hospitals, health agen-
cies, geriatric hospitals, doctors' offices, and
even by the Peace Corps.
In general, this is a welI-written, thorough-
ly researched text, and would be useful for
instructors of nursing assistants or practical
nurses, students themselves, and, in part,
to professional nursing students and their
instructors.
TO
PLAN FOR A LIFETIME
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Marriage is a responsibility that often re-
quires both spiritual and medical assistance
from professional p&ople. In many instances
a nurse may be coiled upon for medical
counsel for the newly married young wo-
man, moth.r, or a matu... woman.
"To Plan For A Lifetime, Plan With Your Dac-
tor" is a pamphlet that was written to assist
in preparing a woman for potient.physicion
discussion of family planning methods. The
booklet st..sses the importance to the indi.
vidual of selecting the method that most
suit. her religious, medical, and psychological
needs.
\-
'-
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\
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Nurses are invited to use the coupon below
ta order copies for use as on aid in coun-
selling. They will be supplied by Mead John.
son Laboratories as a free swvice.
M8a
inmm1
LABORATORIES
'Y<t:fcoæll /ùr Li/é
I ORDER FORM
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capi.. of "To Plan For A Lifetime, Plan With You, I
Doctor" to:
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To: Mead Johnson Laboratories,
111 St. Clair Avenue West,
Toronto 7, Ontario.
54 THE CANADIAN NURSE
films
History of Medicine
The Canadian Medical Association has
prepared a special film for Canada's Cen-
tennial year. A Century of Canadian Medicine
(2S-minute, color, sound) depicts the pro-
gress of medicine Over the past 100 years.
The film demonstrates the profession's
commitment to the improvement of the
nation's health. The life-and-death gambles
with diseases such as pneumonia or tuber-
culosis in IS67 have changed to scenes
where medication and treatment can over-
come the infection, and life goes on with
little interruption. Recent advances in med-
icine and surgery have been selected to
show lay audiences some of the results of
medical progress, such as open-heart sur-
gery, care of premature babies, and the
use of physiological monitors.
As a secondary objective, it is hoped that
the film will stimulate recruitment of
young people interested in and capable of
carrying on the traditions of service and
science.
This centennial film would be of inter-
est to nurses - especially useful in his-
tory courses and as a film to recommend
for showings to high school students. For
information concerning its use, write to
The Secretary, Public Relations, Canadian
Medical Association, 150 St. George Street,
Toronto 5, Ontario.
Through the Eyes of the Patient
An unusual and excelIent teaching film,
Candidate for a Stroke, has recently been
added to the lists of films available from
the Canadian Heart Foundation. In this
film the audience sees the world as through
the eyes of a man having a mild stroke.
Diagnosis, treatment, and rehabilitation are
all seen as though the audience was the
patient. The film also concludes with the
steps necessary to reduce the risk factors
that lead to a cerebrovascular accident.
This IS-minute, black-and-white, sound
film would be valuable as a teaching aid
in medical-surgical nursing. It may be
borrowed from the Canadian Heart Found-
ation, 1130 Bay St., Toronto 5, Ontario.
Dangers of Superficial Relationships
The Special Universe of Walter Krolik,
a new, 2S-minute, color, sound film, pre-
sents a patient-family story. The film was
intended primarily for a nursing audience
and is not suitable for a lay group. It dis-
cusses the outcome of nurse-patient relation-
ships when a response is made to super-
ficial needs without an assessment of un-
derlying needs. In this film, nurses appear
FEBRUARY 1967
films
to be winning the battles and losing the
war.
The film would be an excellent teaching
tool in schools of nursing, or in continuing
education programs for graduates. It is
directly concerned with the patient v.:ith
tuberculosis, but many of the concepts
are applicable to any chronic or continuing
patient care.
The film was prepared in the United
States and was co-sponsored by the Na-
tional Tuberculosis Association, the Nur-
sing Advisory Service on Tuberculosis and
Other Respiratory Diseases, and the ANA-
NLN Film Service. It was made possible by
a grant from the American Contract Bridge
League Foundation. It may be borrowed
from your local branch of the Canadian
Tuberculosis Association.
Excellent for Adolescents
An excellent motion picture on growth
and development for adolescent and teen-
age girls has been produced by Churchill
Films. Girl to Woman is a scientific and
authoritative treatment of the sensitive
subject of puberty, and is produced under
medical and psychiatric supervision. Ex-
tensive animation is used to show the
female reproductive system and the tur-
Nursing Studies Index
A reVISion of the Canadian
Nurses' Association Nursing Studies
Index, first issued in 1964, is in
preparation. If you know of any
studies, i.e., masters and doctoral
theses and studies by government
organizations and institutions,
which have been completed be-
tween 1964 and 1966, or any prior
to 1964 that were missed in the
first issue, please notify the libra-
rian, Canadian Nurses' Association,
50 The Driveway, Ottawa. The
only criteria is that the study be on
some aspect of concern to nursing
in Canada, or, in the case of theses,
be conducted by a Canadian nurse.
Also, the library is hoping to have
as many copies as possible of the
studies listed in the index in the
CNA repository collection of nurs-
ing studies. If you have only one
copy of your study, please lend
it to us with permission to xerox.
FEBRUARY 1967
bulent changes that take place during and
after puberty.
The film is a companion to Boy To Man,
released a few years ago, which has re-
mained the most authoritative film in its
field. It would be valuable for use in schools
as well as a teaching tool for nurses.
The film is in color, and runs 16 minutes.
It may be borrowed from the Canadian
Film Institute, 1762 Carling Ave., Ot-
taWa 13. A small rental fee is charged.
accession list
Publications in this list of material re-
ceived recently in the CNA library are
shown in language of source. The majority
(reference material and theses. indicated by
R, excepted) may be borrowed by CNA
members, and by libraries of hospitals and
schools of nursing and other institutions.
Requests for loans should be made on the
"Request Form for Accession List" (page
57) and should be addressed to: The Li-
brary, Canadian Nurses' Association. 50
The Driveway. Ottawa 4. Ontario.
BOOKS AND DOCUMENTS
I. L'automation par Louis SalJeron. 4. éd.
Paris, Presses Universitaires de France,
1965. 125p. (Que sais-je? no. 723.)
2. Canadian annual revieK for 1965.
Edited by John Saywell. Toronto. Univ. of
Toronto Press. 1966. 569p.
3. Canadian unil'ersities and colleges /966.
ed. by Edward Sheffield and Rosalind J.
Murray. Ottawa. Association of Universities
and Colleges, 1966. 335p.
4. Communication and public relations
by Edward J. Robinson. Columbus, Ohio,
Charles E. Merril Books, c1966. 618p.
5. Continuing professional educational
lIeeds of supervisory personnel in the nursinl!
service and nursing education; a survey of
Pennsylvania hospitals by Sammuel S. Du-
bin and H. LeRoy Marlow. University Park,
Penn., Pennsylvania State Univ., 1965. 65p.
6. La cybernétique par Louis Couffignal.
Paris, Presses Universitaires de France, 1963.
125p. (Que sais-je? no. 638.)
7. The determination and measurement of
supervisory training needs of hospital per-
sonnel; a survey of Pennsylvania hospitals
by Samuel S. Dubin and H. LeRoy Marlow.
University Park. Penn.. Pennsylvania State
Univ., 1965. I32p.
8. Documents fondamentaux; statuts et
règlement directives règlements intérieur
pour les séances par Conseil International
des Infirmières. London. 1966. 47p.
9. Dotation en personnel des services in-
firmiers de santé publique et de soins au.\'
malades non hospitalisés. Méthodes d'étude.
par Doris E. Roberts. Genève, Organisation
mondiale de la Santé. 1965. I IIp.
.;:
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ostomy
anatomical
demonstrator
"MINI-GUIDE"
"
M\lPI!:. -\..'^TUM"'Y
o
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\0 ""./'
"Mini-Guide" allows you to visually and
graphically perform Colostomy, Ileostomy I1eal-
Bladder, Wet Colostomy and Cutaneous Ureterostomy
surgery.
As an instructor, you are afforded a simple, effective method of teac
ing th
surgical
mechanics and organs involved in ostomy surgery; as a student, you Immedmtely see
and understand the procedures o
ostomy surg
ry; and
s a nurse. you have the per-
fect vehicle for visual demonstratIons to the patient who IS to undergo ostomy surgery.
The "Mini-Guide" anatomical demonstrator is priced at $1.00 on this money-back
offer 746 CN.
,
'
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PORT CHESTER . NEW YORK
THE CANADIAN NURSE SS
Next Month
in
The
Canadian
Nurse
. Nursing
in the
north
. Changes
in nursing
education in
Saskatchewan
. RN employed
at a
veterinary
college
ð
Photo credits
Expo 67, p. 7
Globe and Mail, p. 13
USSR Embassy, pp. 27, 29, 32
Dept. of National Health and
Welfare, p. 42
56 THE CANADIAN NURSE
accession list
10. L'équilibre .
ympathique par Paul
Chauchard. Paris. Presses Universitaires de
France, 1961. 128p. (Que sais-je? no. 565.)
I 1. Factors affectin!? the eSlllblishment of
associate degree programs in nursing in
community junior colleges by Mildred S.
Schmidt. New York, National League for
Nursing, 1966. 128p.
12. Final report on draft legislation pre-
pared jor the New Brunswick Association
of Registered Nurses by Alan M. Sinclair.
Fredericton, 1966. Iv.
13. Governments and the university by
York University. Toronto, MacMillan, 1966.
92 p. (The Frank Gerstein lectures, 1966).
14. L'hérédité humaine par Jean Ros-
tand. 6.éd. Paris, Presses Universitaires de
France, 1965. 126p. (Que sais-je? no.550.)
15. History of the school for nurses To-
ronto General Hospital by Margaret Isabel
Lawrence (ed). Toronto, Alumni Associa-
tion, 193 I. 63p.
16. Nursing studies index, mi. 3, 1950-
1956 prepared under Virginia Henderson.
Philadelphia, Lippincott, 1966. 653p. R
17. La projession d'infirmière en France,
2éd. par Revue de I'Infirmière et de l'As-
sistante Sociale. Paris, Expansion Scienti-
fique français, 1962. 377p.
18. Report on action prepared for the
New Brunswick Association of Registered
Nurses by Katherine MacLaggan. Frederic-
ton, 1966. 63p.
19. Le rôle de l'infirmière dans l'action
de santé mentale; rapport sur une confé-
rence technique, Copen hague, 15-24, nO-
vembre 196( par Audrey L. John et al.
Genève, Organisation mondiale de la Santé,
1965. 214p.
20. A series of papers presented at the
1965 regional clinical conferences sponsored
by the American Nurses' Association, New
York, 1966. 6v. Contents. -1. Nursing
practice. -2. Medical-surgical nursing prac-
tice. -3. Maternal and child health nursing
practice. --4. Psychiatric nursing practice.
-5. Public health nursing practice. -6.
Geriatric nursing practice.
21. Les services injirmiers de santé pu-
blique; problèmes et perspectives par Or-
ganisation mondiale de la Santé. Genève.
1961. 208p.
22. The sister as a clinical specialist by
Sister Leon Douville and Sister Marilyn
Emminger. St. Louis, Conference of Catho-
lic Schools of Nursing, 1966. 126p. Q
23. A survey to determine the nursing
care needs of patients in certain standard
welfare wards (indigent) of the Ottawa Civic
Hospial following their discharge from the
hospital by Muriel V. Lowry. Ottawa, 1962.
51p.
24. Le système nerveux par Paul Chau-
chard. 10.éd. Paris, Presses Universitaires de
france, 1966. 128p. (Que sais-je? no. 8.)
25. Les testes mentaux par Pierre Pichot.
Paris. Presses Universitaires de France,
1965. 126p. (Que sais-je ? no. 626.)
PAMPHLETS
26. Book and joumal serl'ices for doctors
and nurses. An interim report on a National
Book League investigation by J.E. Mor-
purgo. London. N uffield Provincial Hospi-
tals Trust. 1966. 41 p.
27. A brief to the .relect committee oj the
New Brunswick legislature on the labour
relations act. Fredericton, New Brunswick
Association of Registered Nurses, 1966.
28. Directory of Canadians with service
overseas, 1966. Ottawa. Overseas Institute
of Canada, 1966. 478p.
29. A guide for the nursing service audil
by Sister Mary Helen Louise Dee1dn. St.
Louis, Catholic Hospital Association, 1960.
26p.
30. A guide for the ulilizalion oj per-
sonnel supportive of public health nursing
service.r. New York, American Nurses' As-
sociation, Public Health Nurses Section.
1966. 12p.
31. Guiding principles for the develop-
ment oj programs in educational institutions
leading to a diploma in nur.ring. Ottawa,
Canadian Nurses' Association, 1966. lip.
32. An index of care by J.A.K. MacDon-
nell and G.B. Murray. Ottawa, Medical
Services J. 31:499-517, Sep. 1965. Reprint.
33. Major official policies relating to the
economic security program. Rev. New York,
Amerioan Nurses' Association, 1965. 14p.
34. NLN accreditation-community nursinl?
services; guide to preparing a report for
evaluation for preliminary accreditation.
New York. National League for Nursing.
Department of Public Health Nursing, 1966.
9p.
35. The planning and organization of
medical book and journal services in region-
al hospitals. A National Book League guide
for librarians. London, Nuffield Provincial
Hospitals Trust. 1966. 34p.
36. Principes directeurs de la mise au
point de programmes dans les maisons d'en-
seignement. en vue de diplôme en sciences
infirmières. Ottawa, Association des In fir-
mières canadiennes, 1966. 12p.
37. Recommendation jrom the Associa-
tion of Nurses of Prince Edward Island re-
garding medical procedures carried out by
nurses. Fredericton, n.d. 2p.
38. Seeking foundation funds by David
M. Church. New York, National Public
Relations Council of Health and Welfare
Services, Inc., c1966. 39p.
39. Statement relative to the national
labor-management relations act, 1947, May
7, 1963. New York, American Nurses' As-
sociation, 1963. lOp.
40. Statistical data associate degree pro-
grams in nursing 1966. New York, Natioool
League for Nursing. Dept. of Associate De-
gree Programs, 1966, 8p.
41. Suggested design guidelines for nur-
FEBRUARY 1967
fare. Public Health Service. Administrative
æpects 0/ hospital central medical and surg-
ical supply senoices. Washington, 1966. 37p.
48. Dept. of Health, Education and Wel-
fare. Public Health Service. Estimating the
cost of illness by Dorothy P. Rice. Washing-
ton, 1966. 131p.
49. Dept. of Health, Education and Wel-
fare. Public Health Service. A manual for
hospital central medical and surgical supply
services. Washington, 1966. 106p.
50. Dept. of Labour. Bureau of Labour
Statistics. Major collective bargaining agree-
ments; arbitration procedures. Washington.
U.S. Govt. Print. Off., 1966. 167p.
51. Dept. of Labour. Bureau of Labour
Statistics. Major collective bargaining agree-
ments; management rights and union-
management co-operation. Washington, U.S.
Govt. Print. Off., 1966. 69p.
52. Dept. of Labour. Women's Bureau.
Handbook on women workers 1960. Wa-
shington. U.S. Govt. Print. Off., 1960. Iv.
53. Dept. of Labour. Women's Bureau.
Nurses and other hospital personnel; their
earnings and employment conditions. Re-
printed with supplement. Washington, U.S.
GOVI. Print. Off., 1961. 41p.
A.) - Toronto. R
55. The historical dnelopment of one
aspect of curriculum development in nursing
education by Sister Marie Bonin. Washing-
ton, 1965. Thesis (M.Sc.N.) - 1965. R
56. Methods of evaluating the senoice of
professional nursing students in selected
schools of nursing by Margaret Mary Street,
Boston, 1961. 105p. Thesis (M.Sc.N.) -
Boston. R
57. The preparation of survey schedules
for the selection of the facilities in three
Canadian provinces for the organization of
a collegiate program in nursing by Sister
Jeanne Forest. Washington, 1945. Thesis
(M.Sc.N.Ed.) - Catholic Univ. of America.
108p. R
58. Relationship between achie
'ement in
high school and achievement on the exa-
minations for admission to practice nursing
in Canada by Sister Claire Jeannatte. Wash-
ington, 1965. Thesis (M.Sc.N.) - Catholic
Univ. of America. 44p. R
59. A study of the educational value 0/
a learning experience in a rural hospital
setting by Sister Marguerite Letourneau.
Washington, 1963. Thesis (M.Sc.N.) -
Catholic Univ. of America. 89 p. R
60. A study of performance on pre-en-
trance tests and examinations for admission
10 practice and the relationship between
these tests by Sister Jeannette Gagnon.
Washington. 1963. Thesis (M.A.) - Catho-
lic Univ. of America. 54p. R
accession list
sing education facilities; schools of nursing.
Toronto. Ontario Hospital Services Com-
mission. 1966. 5p.
42. Sun'ey of employment conditions of
nurses employed by physicians and for
dentists, July 1964. New York, American
Nurses' Association. Research and Statistics
Unit, 1965. 24p.
GOVERNMENT DOCUMENTS
Canada
43. Dept. of Labour. Labour-Management
Co-operation Service. Labour management
Committee material, order book. Ottawa.
Queen's Printer, 1966. 3Op.
44. Dominion Bureau of Statistics. Census
of Canada 1961. General review. Housing
in Canada. Ottawa, Queen's Priner, 1966.
79p.
45. Parliament. House of Commons. Bill
C-170; an act respecting employer and em-
ployee relations in the Public Service of
Canada. Ottawa. 1966. 53p.
Nova Scotia
46. Dept. of Labour. Economics and Re-
search Division. Wage rates and hours of
labour in Nova Scotia. Halifax. 1966, 226p.
United States
47. Dept. of Health, Education and Wel-
STUDIES DEPOSITED IN CNA REPOSITORY
COLLECTION.
54. An enquiry into the need lor conti-
nuing education for registered nurses in
the prm'ince of Ontario by M. Josephine
Flaherty. Toronto. 1965. 176p. Thesis (M.
Request Form
for "Accession List"
CANADIAN NURSES'
ASSOCIATION LIBRARY
++++++++++
++++++++++
++
.+++++++
++
++++++
++++'++++++
++++++++++
++++++++++
+++++
Send to:
LIBRARIAN, Canadian Nurses' Association,
50 The Driveway, Ottawa 4, Ontario.
Please lend me the following publications, listed in the
..... ........ issue of The Canadian Nurse,
or add my name to the waiting list to receive them when
available.
Item Author Short title (for identification)
No.
Tums
consume
93 times their
own weight
in excess
stomach
acid!
Laboratory tests show Tums neu-
tralize 93 times their own weight
in excess stomach acids, and that
they maintain a balanced level for
long periods, too. Turns go to work
in 4 seconds on gas, heartburn and
indigestion. And they taste pleas-
antly minty, need no water and
cost so very little. Those are the
facts. So next time your tummy
gives you a turn, give Tums a try.
They're worth their weight in gold !
4llO
$.
Request for loans will be filled in order of receipt
Reference and restricted material must be used in the
CNA library.
Borrower
Position
Address ..
Date requested ..
think how fast they'll work
on your tummy upsets!
FEBRUARY 1967
THE CANADIAN NURSE 57
classified advertisements
I I
I
I
ALBERTA
BRITISH COLUMBIA
NIGHT SUPERVISOR, R.N. AND MEDICAL HEAD
NURSE for 9O-bed octive treatment hospital in the
City of Wetoskiwin, situated midway between Ed.
monton and Red Deer. Residence accommodation
available, excellent salary ranges and fringe benefits
in effect, as well as payment for prior experience.
Apply to: Director of Nursing, Municipal Hospital,
Wetaskiwin, Alberta. 1.96-1
Regiltered Nurse. far new SO.bed active treatment
hospital, situated only 15 miles from Edmonton.
Salary $360 - $420 per month. Recognition given for
previous experience Excellent personnel policies and
working conditions. For further information please
write to: Miss M. Macintosh, R.N., Director of
Nursing, Fort Saskatchewan General Hospital, Box
12 70, fort Sask a tchewan, Alberta. 1-39-2
Regist.r.d Nurses (5) required (summer relief or per-
manent posts) for May 1967. The Peace River Municipal
Hospital, Alberta, was built 5 years ago and has a
complement of 70 beds. Starting salary for 1966
$370. New salary scales expected for 1967. Peace
River is a progressive town and a beauty spot on the
Prairies. Apply to: The Director of Nursing for fuller
particulars. Peace River, Municipal Hospital, Peace
River, Alberta. 1-69-1
Registered Nunes and Certified Nursing Aides for
17-bed hospital. Salary for Graduate Nurses basic
$400 to $460. Certified Nursing Aides $240 to $280
with credit for previoue experience. Full maintenance
available at $35 per month. Apply to: Miss A. Nun.
weiler, Director of Nursing, Oyen Municipal Hospital,
Oyen, Alberta. Telephone: 664-3 553 1-68-1
General Duty Nurses (2) for a modern general 30-
bed hospital. East Central Alberta Highwoy 12.
Salary according to experience. vearly increments.
AARN personnel policies. Apply to: Sister Adminis-
trator, Our Lady of the Rosary Hospital, Castor,
Alberta. 1-19-1
ADVERTISING
RATES
FOR All
CLASSIFIED ADVERTISING
$10.00 for 6 lines or less
$2.00 for each additional line
Rates for display
advertisements on request
Closing date for copy and cancellation is
6 weeks prior to 1st day of publication
month.
The Canadian Nurses' Association has
not yet reviewed the personnel policies
of the hospitals and agencies advertising
In the Journal. For authentic information,
prospective applicants should apply to
the Registered Nurses' ASsociation of the
ProvInce in which they are interested
in working.
Address correspondence to:
The
Canadian ð
Nurse v
50 THE DRIVEWAY
OTTAWA 4, ONTARIO.
58 THE CANADIAN NURSE
I I
ALBERTA
REGISTERED NURSES fOR GENERAL DUTY (WANTED)
for a 37-bed General Hospital. Salary $380 - $440
per month. Commencing with $375 with 1 year and
$390 with 3 years. practical experience elsewhere.
Full maintenance available at $35 per month. Pen-
sion plan available, train fare from any point in
Canada will be refunded after 1 year emplovment.
Hospital located in a town of 1,100 population, 85
miles from Capital City on a paved highway.
Apply to: Two Hills Municipal Ho.pital, Two Hills,
Alberta. 1-88-1
NURSES fOR GENERAL DUTY in active 30-bed hospital,
recently constructed building. Town on main line of
the C.P.R. and on Number 1 highway, midway
between the cities of Calgary and Medicine Hat.
Nurses on staff must be willing and able to take re-
sponsibility in all departments of nursing, with the
exceptions of the Operating Room. Recently renovated
nurses' residence with all single rooms situated on
hospital grounds. Apply to: Mrs. M. Hislop, Adminis-
trator and Director of Nursing, Bassano General Hos-
pital, Bassano. Alberta. 1-5-1
General Duty Nurses for an active accredited well
equipped 64.bed hospital in a growing town, popu-
lotion 3,500. Centrally located between maior cities.
Full maintenance available in a new residence, $35.00
per month. Alberta Registered Nurses salary $360.00
- $420.00, commensurate with experience. Excellent
personnel policies and working conditions. Apply:
Director of Nursing, Brooks General Hospitol, Brooks,
Alberta. 1-13-1 A
GENERAL DUTY NURSES for modern 25-bed hos-
pital on Highwoy No. 12, East-Central Alberta.
Salary range $380 to $440. (including a regionol
differential). New staff residence. Full maintenance
$35. Personnel policies as per AARN. Apply to the:
Director of Nursing, Coronation Municipal Hospital.
Coronotion, Alberta. Tel.: 578-3803. 1-25-IB
GENERAL DUTY NURSES for 64-bed, active treatment
hospital, 35 miles South of Calgary. Salary range
$360 - $420. Living accommodation available in
separate residence if desired. Full maintenance in
residence $35 per month. 30 days paid vacation after
12 months employment. Please apply to: The Director
of Nursing, High River Municipal Hospital, H
gh
River, Alberta. 1-46-1
GENERAL DUTY NURSES: Modern 26-bed hospital
close to Edmonton. 3 buses daily. Salary $360.00 to
$420.00 per month commensurate with experience.
Residence available $35.00 per month. Excellent
personnel policies. Apply: Director of Nursing,
Mayerthorpe Municipal Hospital, Moyerthorpe, Al-
berta. 1-61-1
GENERAL DUTY NURSES for 94-bed General Hospital
located in Alberta's unique Dinosaur Badlands. $360
- $420 per month, 40 hour week, 31 days vacation,
pension, Blue Cross, M.S.I. and generous sick time.
Apply to: Miss M. Hawkes, Director of Nursing, Drum-
heller General Hospital, Drumheller, Alberta. 1-31-2 A
General Duty Nurses and Certified Nursing Aides for
modern combined active treatment and Auxiliary
Hospital. Salary starts at $355 and $240 respectively.
Liberal personnel policies. accommodation available.
Located in Southern Alberta close to U. S. boundary
and Waterton-Glacier International Peace Park. The
61-bed combined hospital serves the town and area of
approximately 6,000 population with all services.
Apply to: The Director of Nursing, Cardston Municipal
Hospital, Box 310, Cardston, Alberta. 1-17-1
GENERAL DUTY NURSES (6) and CERTifiED NURS-
ING AIDES for modern 72-bed hospital. Salary $355
and $240 respectively; credit for experience; liberal
policies. Accommodation available. Apply to: Ad-
ministrator, Providence Hospital, High Prairie, Al-
berta. 1-45- I
BRITISH COLUMBIA
Operating Raam Heod Nurse ($464. $552), Generol
Duty Nunes (B.C. Registered $405 - $481, non-RegIS-
tered $390) for fully accredited 113-bed hospital in
N.W. B.C. Excellent fishing, skiing, skating, curling
and bowling. Hot springs swimming nearby. Nurses'
residence, room $20 per month. Cafeteria meals.
Apply: Director of Nursing, Kitimat General Hospital,
Kitimat, British Columbia. 2-36-1
Royal Jubilee Hospital, Victoria, B.C., invites B.C.
Registered Nur.es (ar tho.. eligible) to apply for
pOlitions in Medicine, Surgery and Psychiatry. Apply
to: Director of Nursing. Victoria, British Columbia.
2.76-4A
B_C. R.N. far Generol Duty in 32 bed General Hospi-
tal. RNABC 1967 salary rate $390 - $466 and fringe
benefits, modern, comfortable, nurses' residence in
attractive community close to Vancouver, B.C. For
application form wtlte: Director of Nursing, Fraser
Canyon Hos pital, R. R. I, Hope, B.L 2-30.1
GENERAL DUTY NURSES (Twa) for active 66-bed
hospital, with new hospital to open in 1968
Active in-service programme. Salary range $372 to
$444 per month. Personnel policies according to
current RNABC contract. Hospital situated in beauti-
ful East Kootenays of British Columbia, with swim-
ming, golfing and skiing facilities readily availab:e.
Apply to: The Director of Nursing, St. Eugene Hos-
pital, Cranbrook, British Columbia. 2-15-1
General Duty Nurses for active 3D-bed hospital.
RNABC policies and schedules in effect, also North-
ern allowance. Accommodations available in res-
Idence. Apply: Direc.tor of Nursing, General Hospital,
fort Nelson, Bntl,h Columbia. 2-23-1
General Duty Nurses for new 30-bed hospital
located in excellent recreational area. Salary ond
personnel policies in accordance with RNABC. Com.
fortable Nurses' home. Apply: Director of Nursing,
Boundary Hospital, Grand Forks, British Columbia.
2-27.2
General Duty Nurse. (2 immediately) for active.
26-bed hospital in the heart of the Rocky Mountains,
90 miles from Banff and Lake Louise. Accommodo-
tion available in attractive nurses' residence. Apply
giving full details of training, experience, etc. to:
Administrator, Windermere District Hospital, Inver-
mere, Brit ish Columbia. 2-31-1
General Duty Nurscs for new 37-bed hospital.
Located in Southwest British Columbia. Salary and
personnel policies in accordance with RNABC. $390
to $466. Accommodation available in residence. Apply
to: Director of Nursing. Nicola Valley General Hos
pital, Box 129, Merrill, British Columbia. 2-41-1
Generol Duty Nurses for well-equipped 80.bed Gener-
al Hospital in beautiful inland Valley adjacent Lake
v.:athlyn and Hudson Bay Glacier. Initial sa lory $387.
Maintenance $60, 40 hour 5 day week. vacation with
pay, comfortable. attractive nurses' residence.
Sooting, fishing, swimming, golfing, curling, skating,
skiing. Apply to: Director of Nursing, Bulkley Valley
District Hospital, P.O. Box No. 370, Smithers, British
Columbia. 2-67-1
GENERAL DUTY NURSES Salary - non B.C
registerea $375 per month - B.L registered $390.
$466, depending on experience. RNABC policies i"
effect. Nurses' residence available. Group Medical
Health Plan. All winter and summer sports. Apply:
Director of Nursing, Cariboo Memorial Hospital. Wil
Iiams Lake, British Columbia. 2-80-1 A
General Duty O. R. and experienced Obstetrical
Nurses for modern, 150-bed hospital located in the
beautiful Fraser ValleYa Personnel policies in ac-
cordance with RNABC. Apply to: Director of Nursing,
Chilliwack General Hospital, Chilliwack, British Co
lumbia. 2-13-1
General Duty and Operating Room Nurses far 70-bed
Acute General Hospital on Pocific Coast. B.C. Regis
tered $390 - $466 per month (Credit for experience)
Non B.L Registered $375 - Practical Nurses B.L LI
censed $273 - $311 per month. Non Registered $253-
$286 per month. Board $20 per month, room $5.00 per
month. 20 paid holidays per year and 10 statutory
holidays after 1 year. Fare paid from Vancouver.
Superannuation and medical plans. Apply: Director of
Nursing. St. George's Hospital, Albert Bay, Britis'"
Columbia. 2-2-1 A
General Duty, Operating Room and Experienced
Obstetricol Nurse. for 434-bed hospital with school
of nursing. Salary: $372.$444. Credit for post ex-
perience and postgraduate training. 40.hr. wk. Stat
utory holidays. Annual increments; cumulative lick
leave; pension plan; 28-daYI annual vacation; B.C-
registration required. .Apply: Director. of Nurs.i':lg.
Royal Columbian Hospital, New Westminster, Bfltll
Columbia. 2-73-13
Groduote Nune. for 31-bed hospital on B.L Coast
Salary $372 for B. C. Registered Nurses plus $I
northern living allowance. Personnel policies in
accordance with RNABC. Travel from Vancouver
refunded after 6 mos. Apply: Administrat.jr, General
Hospital, Ocean falls, British Columbia. 2-49-1
GRADUATE NURSES for 24.bed hospital, 35-mi. from
Vancouver, on coast, salary and personnel proc-
tices in accord with RNABC. Accommodation availa.
ble. Apply: Director of Nursing, General Hospital,
Squamilh, British Columbia. 2-68.'
FEBRUARY 1967
BRITISH COLUMBIA
General Duty and Op.rating Room Nunes for
modern 450-bed hospital with School of Nursing.
RNABC policies in effect. Credit for past experience
and postgraduate training. British Columbia registra-
tion required. For particulars write to: the Director of
Nursing Service, St. Joseph's Hospital, Victoria, British
Columbia. 2-76-5
GRADUATE NURSES for busy 21-bed general hospital
preferably with obstetrical experience. Friendly at-
mosphere, beautiful beaches, local curl ing club.
Own room and board $40 month. Basic salary $357
or $372 plus recognition for post graduate ex-
perience. Apply Matron, Tofino General Hospital,
Tofino, Vancouver Island, B_ C 2-71-1
MANITOBA
Director 0' Nurs.. for up-fa-date 38-bed hospital.
New nurses' residence of 196.4 has separate nurses
suite available. Sick leave, pension plan and other
fringe benefits available. Personnel policies will be
sent on request. Enquiries should include experience,
qualifications and salary expected, and should be
addressed to: Mr. O. Hamm, Administrator, Altona
Hospital District No. 24, Box 660, Allona, Manitoba.
3-1-1
RegIstered Nurses (2) for 50-bed General Hospital in
Fort Churchill, Manitoba. Slarting salary $470 per
month with higher 1967 schedule effective January 1.
Train fare from Winnipeg refunded after six months
service, and return fare refunded after one year
service. Apply to: Director of Nursing. For
Churchill General Hospital, Fort Churchill, Mani-
toba. 3-75-1
Regislered Nurses (2) for 10-bed hospital 01 Fisher
Branch. Manitoba. Starting salary $400/m. Duties to
commence as soon as possible. Residence accom-
modation available. For further information and ap-
plication forms. apply to: Matron, Fisher Branch
Hospital, Fisher Branch, Manitoba. 2-23-2
Registered Nurse' for 18-bed hospital at Vita Manitoba,
70 miles from Winnipeg. Daily bus service. Salary
range $380 - $440, with allowance for experience.
40 hour weeK, 10 statutory holidays, 4 weeks paid
"acation after one year. Full maintenance available
for $50 per monlh. Apply: Malron, Vita Districl
Hospital, Vita, Manitoba. 3-68-1
Registered Nurses and licensed Practical Nurses for
232-bed Children's Hospital, with school of nursing;
active teaching center. Positions available on all
services. Apply: Director of Nursing, Children's Hos-
pital, Winnipeg 3, Manitoba. 3-72- 1
Registered Nurse for General Duty in 20-bed hospital.
Salary range $380 - $440 per month to be increased
Jan. 1, 1967. Room and board available 01 $55.50
per month. Generous personnel policies. Full details
ovailable on request. Apply: Director of Nursing,
Reston Community Hospital, Reston, Man. 3-46-2
General Duty Nurses for 100-bed active treatment hos-
pital. Fully accredited. 50 miles from Winnipeg on
Trans Canada Highway. Apply: Director of Nursing
Service. Portage District General Hospital, Portage La
Prairie, Monitoba. 3-45-1
NOVA SCOTIA
REGISTERED NURSES for 53-bed medium and long-
term active treatment hospital in a progressive city.
Particulars on request. Apply to: Director of Nursing,
Holifax Civic Hospital, 5938 University Avenue, Hali-
fax, Nova Scotia. 6-17-10 A
Registered Nurse. for 21.bed hospilal in pleasant
community - Eastern Shore of Nova Scotia. Apply:
Superintendent, Eastern Shore Memorial Hospital.
Sheet Harbour, Nova Scotia. 6-32- 1
ONTARIO
Co-ordinator of Clinical Nursing Studies in the
Bachelor of Science in Nursing Course: The School
of Nursing, McMaster University, invites applications
from persons with advanced qualifications in clinical
nursing. The position is open for the 1967-1968
session, with duties commencing July 1967. Please
apply sending curriculum vitae and two references
to: Director, School of Nursing, McMaster University,
Hamilton, Ontario. 7-55-15
FEBRUARY 1%7
I I
ONTARIO
Registered Nurse, for 34.bed hospital, min. salary
$387 with regular annual increments to maximum
of $462. 3-wk. vacation with pay; sick leave after
6-mo. service. All Staff 5 day 4()'hr. wk., 9
statutory holidays, pension plan and other benefits
Apply to: Superintendent, Englehart & District Hos
pital, Englehart, Ontario. 7-40-t
Registered Nurses. Applications and enquiries are
invited for general duty positions on the staff of the
Manitouwadge General Hospital. Excellent so lory
and fringe benefits. liberal policies regarding ac.
commodation and vacation. Modern well-equipped
33-bed hospital in new mining town, about 250-mi.
east of Port Arthur and north-west of White River,
Ontario Pop. 3,500. Nurses' residence comprises indiA
v
dual self-contained opts. Apply, stating qualifica.
tions, experience, age, marital status, phone number,
etc. to the Administrator, General Hospital, Mani
touwadge, Ontario. Phone 826-3251 7-74-1 A
Registered Nurses: Applications are invited for Gener
01 Duty Staff Nurses; Gross salary range: $362 to
$422. Supervisory advancement opportunities. Resident
accommodations avaitable; Hospital situated in tourist
tawn off Lake Huron. For further information write:
Superintendent, Saugeen Memorial Hospital, South-
ampton, Ontario. 7-122-1
Registered Nurses for 35-bed active treatment hospital,
35 miles north east of Toronto, Ontario. Minimum
salary $355 per month, and annual increments. Per
sonnel policies including, Medical, O.H.S.C.. weekly
Indemnity Insurance, Ontario Hospital Pension Plan,
and Group Life Insurance shared by the hospital, plus
other benefils_ Apply 10: The Superintendent, The
Collage Hospital (Uxbridge), Uxbridge, Ontano.
7.135-1
Registered Nurses for 18-bed (expanding to 36 bed)
General Hospital in Mining and Resort town of 5,000
people. Beautifully located on Wawa Lake, 140 miles
north of Sault Ste. Marie, Ontario. Wide variety of
summer and winter sports including swimming, boat.
ing, fishing, golfing, skating, curling and bowling.
Six churches of different faiths. Salaries comporable
with all northern hospitals. limited bed and board
available at reasonable rate. Excellent personnel
policies, pleasant working conditions. Apply to:
Director of Nursing, The Lady Dunn General Hospifal,
Box 179, Wawa, Ontario_ 7-140-1 B
Registered Nunes and Registered Nursing AsslstanlS.
for lOO-bed General Hospital, situated in northern
Ontario. Starting salary, Registered Nurses $390 per
month. Registered Nursing Assistants $273 per month,
shift differential, annual increment, 40 hour week.
O. H. A. pension plan and group life insurance.
O. H. S_ C. and P. S. I. plans in effect_ Accommoda
tion available in residence if desired. For full par-
tkulors apply: The Director of Nurses, Lady Minto
Hospital, Cochrc.ne, Ontario. 7-30- 1 A
Registered Nurses and Registered Nursing Assistants
are invited to make opplicotion to our 75-bed.
.nodern General Hospital. You wHi be in the Vaca
tionland of the North, midway between the Lakehead
and Winnipeg, Manitoba. Basic salories are $371
and $259, with yearly increments. Write or phone:
The Director of Nursing, Dryden District General
Hospital, DRYDEN, Ontario. 7-26-IA
REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS (IMMEDIATELY) for a new 40-bed hos-
pital with nurses' residence. Nurses - minimum salary
$387 plus experience allowance, 3 semi-annual incre-
menls of $10 each. R_N.A:s . $270 plus experience
allowance, 2 onnual increments of $10 each. Reply to:
The Director of Nursing, Geraldton District Hospital,
Geraldlon, Ontario. 7-50-1
Registered Nunes and Registered Nursing Assistants
for 160-bed accredited hospitaL Starting salary $415
and $285 respectively with regular annual incre-
ments for botn. Excellent personnel policies. Resid.
ence accommodation avo ilable. Apply to: Director of
Nursing, Kirkland & District Hospilal, Kirkland Lake,
Ontario. 7-67.1
Registered Nurses and Registered Nursing Assistants
for 123-bed accredited hospital. Starting salary $400
and $255 respectively with regular increments for
both. Usual fringe benefits. For full information,
apply to: Director of Nursing, Dufferin Area Hos-
pital, Orangeville, Ontario. Phone 941-2410_ 7-90-1
Registered Nurses and Registered Nursing Assistants:
Applications are invited from R. N's and R. N. Ass'ts.
who are interested in returning to "nursing at the
bedside" in a well-equipped General Hospital. Excel.
lent starting salaries and fringe benefits now. Further
increase January 1. 1967. Residence accommodation if
desired. For full particulars write to: Director of
Nursing, Sioux Lookout General Hospital, P. O. Box
909, Sioux Lookout, Ontario. 7-119-1 A
I I
ONTARIO
Registered or Graduate Nurses, required for modern
92-bed hospital. Residence accommodation $20 month-
ly. Overseas nurses VI. elcome. lovely old Scottish
Town near Ottowa. Apply: Director of Nursing, The
Great War Memorial Hospital, Perth, Ontario. 7-100-2
Registered Nurses for General Duty in well.equipped
2B-bed hospital, located in growing gold mining
and tourist area, north of Kenora, Ontario. Modern
residence with individual rooms; room, board and
uniform laundry only $45. 40-hr. wk., no split shift,
cumularive sick time, 8 statutory holidays and 28
day paid vacatian after one year. Starting salary
$400. Apply to: Matron, Margaret Cochenour Memo-
rial Hospital, Cochenour, Ontario. 7-29-1
Registered Nurses for General Duty and Operating
Room, in modern 100.bed hospital, situated 40 miles
from Ottawa. Excellent personnel policies. Residence
accommodation available. Apply to: Director of
Nursing, Smiths Falls Public Hospital, Smiths Falls,
Ontario. 7-120-2A
Registered Nurses for General Duty in lOO.bed hos-
pital, located 3D-mi. from OUawa, are urgently reo
quired. Good personnel policies, accommodation
available in new staff residence. Apply: Director of
Nursing, District Memorial Hospital, Winchester, On
Iorio. 7-144.1
Registered Nurses 'or General DUlY and Operating
Room in modern hospital (opened in 1956). Situated
in the Nickel Capital of the world, pop. 80,000
people. Salary $372 per moo, with annual merit
Increments, plLs annual bonus plan, 40.hr. wk. Recog-
nition for experience. Good personnel pollcies_ Assist
once with transportation can be arranged. Apply:
Director of Nursing, Memorial Hospitol, Sudbury,
Ontario_ 7-127-4
General Duty Nurses for 66-bed General Hospital.
Starting salary: $375/m. Excellent personnel policies.
Pension plan, hfe insurance, etc., residence accom-
modation. Only 10 min. from downtown Buffalo.
Apply: Director of Nursing, Douglas Memorial Hos-
pital, Fort Erie, Ontorio. 7-45-1
General Duty Nurses for octive General 77-bed Hos-
pital in heart of Muskoka lakes area: salary range
$400 - 5460 with consideration for previous experience;
excellent personnel policies and fringe benefits:nurses'
residence availoble. Apply to: Director of Nursing,
Huntsville District Memorial Hospita), Huntsville, On-
tario_ 7-59-1
General Duty Nurses for 100-bed modern hospital.
Southwestern Ontorio, 32 mi. from London. Salary
commensurate with experience and ability; $398/m
basic solary. Pension plan. Apply giving full par-
ticulars to: The Director of Nurses, District Memorial
Hospilal, Tillsonburg, Ontario. 7-131-1
General Duty Nurses, Certified Nursing Assistants &
Operating Raam Technician (1) for new 50-bed hos.
Pltal with modern equipment, 40.hr. wk., 8 statutory
holidays, excellent personnel policies & opportunity
for advancement. Tourist town on Georgian Bay.
Good bus connections to Toronto. Apply to: Director
of Nurses, General Hospital, Meaford, Ontario. 7-79-1
General Staff Nurse. and Registered Nursing Assis-
tants are required for a modern, well-equipped General
Hospital currently expanding to 167 beds. Situated in
a progressive community in South Western Ontario, 30
miles from Windsor.Detroit Border. Salary scaled to
experience and qualifications. Excellent employee
benefits and working conditions plus an opportunity
to work in a Patient Centered Nursing Service. Write
for further information to: Miss Patricia McGee, B.
Sc.N., Reg.N. Director of Nursing, Leamington District
Memorial Hospital, Leamington, Ontario. 7-69-1 A
OPERATING ROOM NURSES (2) for a fully ac-
credited 70-bed General Hospital. For Operating
Room Duty. Salary according to experience. Apply 10:
O.R. Supervisor, penetanguishene General Hospital,
Penetanguishene, Ontario. 7-99-2
Public Health Nurses for generalized program. Every
modern fringe benefit. Full credit for experience.
Present salary range $5,030 - $6,148. Further, we
are prepared to give consideration to any salary
request. Apply to: E. G_ Brown, M.D., D.P.H. Direclor
and M.O.H., Kent County Health Unit, 21 - 7th. St.,
Chatham, Ontario_ 7-24-4
PUBLIC HEALTH NURSES (2 QUALIFIED) - Stoff
positions ovailable in the City of Oshawa. Duties to
commence January 3rd, 1967. Generalized program
in an official agency. Salary $5,658 to $6,507.
8eginning salory according to experience. liberal
personnel policies and fringe benefits. Apply to: Mr.
D. Murray, Personnel Officer, City Hall, 50 Centre
Street, Oshowa, Ontario. 7-92-2
THE CANADIAN NURSE 59
NURSE-
ANESTHETIST -08
For 350 Bed Commun!ty
Teaching Hospital, 35 mIn-
utes from Metropolitan New
York.
Excellent Salary
+ Benefits
In-service Education
. . 8 Paid Holidays per year
. . Tuition Refund Program
. . 12 Paid Sick Days
per year
. . Free Life and
Disability Insurance
. . Blue Cross Coverage
.
Send Resume to:
Box CN 1433,
125 West 41 St.
New York NY 10036
An Equal Opportunity
Employer MfF
RIVERSIDE
HOSPITAL
OF OTTAWA
A new, air-conditioned 340-bed
hospital. Applications are called
for Nurses for the positions of:
HEAD NURSE - Operating Room
ASSISTANT HEAD NURSES
GENERAL STAFF NURSES
and
REGISTERED NURSING ASSISTANTS
Address all enquiries to:
Director of Nursing
RIVERSIDE HOSPITAL OF OTT A W A
1967 Riverside Drive,
Ottawa, Ontario
60 THE CANADIAN NURSE
ONTARIO
Public Health Nurses for generalized programme in
a Counly.Cily Health Unil. Salary schedule as of
January 1, 1967, $5,100 10 $6,100. 20 days vacalion.
Errp10yer sh":Jred pension plan, P.S.I. and hos;>ital-
\z":]t:on. Mi1eage allowance or unit cars. Apply to:
M'S5 Veronica Q'Le:.ry, Sl..pervisor of Public Health
Nursing, Pele,borough Counly-Cily Heallh Unil, P.O.
Box 246, Pelerborough, Onlario. 7-101-4A
PUBLIC HEALTH NURSES for generalized public health
program. Good personnel policies inciLding .4 weeks'
vacation, sick time allowance, unit COf or Car allow-
ance, shared pension plan, hospitalization, and
group insurance available. Apply to: Mrs. Muriel
McAvoy, Secretary-Treasurer, Porcupine Health Unit,
70 Balsam Slreel Soulh, Timmins, Onlario. 7.132-2
QUEBEC
EXPO 67, NURSES, BE WISE... Reserve your room
now for Expo 67. Semi-private rooms for one person
in a modern home at 10 minutes from Expo grounds.
Rate:$15 per day, including morning coffee and
transportation to Expo site. Please write to: Mme
Marguerile Richard, R.N., 3585, Beaufort, Ville Bros-
sard. Quèbec. 9-86-3
GRADUATE NURSE for Privale Camp in Ihe Lauren.
lions. JULY AND AUGUST 1967. Wrile: PripSlein's
Camp Inc., 6344 MacDonald Avenue, Monlreal 29,
Quebec. 9-86-5
OPERATING ROOM STAFF NURSES: (Applicalions are
inviled). In a modern 350-bed hospilal. Salaries com-
mensurate with experience and postgraduate educa.
tion. Cumulative sick leave, 28 days cnual vacation,
retirement plan and other liberal fringe benefits.
Apply: Director of Nursing Service, St. Mcry's Hospital,
3830 Lacombe Avenue, Monlreal, Quebec. 9-47-39 A
SASKATCHEWAN
DIRECTOR OF NURSING for modern 24-bed aClive
treatment hospital. Graduates in nursing administration
or with experience will be given preference. Accommo-
dation available in nurses' residence. Salary schedule
will be based on Ihe SRNA recommandalions. Apply:
Mr. R. Holinaty, Administrator, Wakaw Union Hospital,
Wakaw, Saskalchewan. 1()"131.1 A
MATRON for Ihe 2()"bed, new, air.condilioned Cabri
Union Hospilal. Salary according to SRNA schedule.
Residence accommodation available. Reply to: Mr. K.
Exner, Secretary-Treasurer, Cabri Union Hospital, Ca-
bri, Saskalchewan. 1 ()"13-2
Regislered Nurses (2) wanted immedialely for Ihe
20-bed, air.conditioned, new hospital. Salary in ac-
cordance wilh Ihe SRNA schedule. Residence aCcom.
modation available. Reply to: Mr. K. C. Exner,
Secretary.Treasurer, Cabri Union Hospital, Cabri, Sas-
kalchewan. 1()..13-1
Registered Nurses (2) for modern 30.bed General Hos-
pilol at 5hellbrook, Sask., 1967 salory $364 - $464
accommodation available in new residence, rates
nominal, personnel policies in accordance to SRNA.
Shellbrook is 27 miles from cily on Allwealher High.
way, near Waskesiu summer resort. Write the Ad.
ministrator, Box 70 - Shell brook Union Hospital,
Shellbrooke, Saskalchewan. 10.118-1
REGISTERED NURSES for 24-bed aclive treatment hos-
pilal. Eslablished personnel policies and pension plan.
Salary range as per SRNA recommendations. Adjust-
ments to starting solary made for previous experience.
Residence accommodation available at 543.50 per
manlh. Apply: Mr.. Z. Johnson, Acting Direclor of
Nursing, Wakaw Union Hospital, Wakaw, Saskatche.
Wan. 10.131-1
Regislered Nursel for Gene,ol Duty (2) in fully
modern 27.bed hospital. Initial salary $364 per monlh.
Personnel policies according to Sask. Reg. Nurses' As-
sociation recommendations. New modern residence,
excellent working conditions. Duties to commence
when convenient. Apply to: Superintendent of Nursing
Services. Kipling Memorial Union Hospital, Kipling,
Saskalchewan. 1 ()"59-1
General Duty and Operating Room NUlle., also
Certified NUlling A.liltan'l for 560-bed University
Hospital. Salary commensurate with experience and
preparations. Excellent personnel policies. Excellent
opportunities to engage in progressive nursing. Ap.
ply: Director of Personnel, University Hospital, 50s.
kaloon, Saskalchewan. 10.1 16-4A
I I
INSTRUCTORS IN ALL NURSING AREAS required by I
School of Nursing, Regina, Saskalchewan. Offen
3 year and 2 year programs. Enrolment 180. Pre-
ference given to applicants with experience in
nursing education or nursing service. Degree prefer
red. Salary as sel by SRNA. Apply to: Direclor,
School of Nursing, Regina Grey Nun's Hospilal,
REGINA, Saskatchewan. 10-109-7
I I
SASKATCHEWAN
UNITED STATES
REGISTERED NURSES - Soulhern California - Op-
parlunilies available - 368-bed modern haspilal In
Medical-Surgical, Labor and Delivery, Nursey, Oper-
ating Room and Intensive and Coronary Care Units.
Good salary and liberal fringe benefils. Conlinuing
rnservice education program a Located 10 miles from
Los Angeles near skiing, swimming, cultural and edu.
cational facilities. Temporary living accommodations.
Apply: Direclor of Nursing Service, SainI Joseph
Hospilal, Burbank, California 91503. 15-5-63
REGISTERED NURSES needed for rapidly expanding
general hospital on the beautiful Peninsula neor
San Francisco. Outstanding policies and benefits,
including temporary accommodations at low cost,
health coverage, fully refundable retirement plan,
liberal shift differentials, no rotation, exceptional
In-service and orientation programs, unlimited sick
leave accrual, unlimited vacation accrual, sick leave
conversion to vacation, tuition reimbursement. Ex-
cellent salaries based on experience. Contact Person
nel Administrator, Peninsula Hospital, 1783 EI
Camino Real, Burlingame, California - 697't1061.
15-5-201\
Regiltered Nurse.. The Los Angeles Counly General
Hospital has opportunities in all clinical areaS. We
invite "/Our enquiries about positions available in pre-
mature nursery, neuro-surgery, pediatrics, operoting
room and recovery room, as well as general medicol
or surg ical words. Several speciclty programs are
planned for 1967. Slarling salary wilh one year's ex-
perience in an accredited hospital is $591 per month,
$624 after six manlhs. Addilional pay for a degree_
Evening bonus approximalely $60 per monlh. Night
bonus $50. Living quarters available on hospital
grounds for 01 leasl 90 days. We will help you wilh
California Registration. For further information,
wrile: Mrs. Dorolhy Easley, Box 1311 CN. Los Angeles
Counly General Hospilal, 1200 Norlh Slale Slreel, Los
Angeles, California 90033. 15-5-3 E
REGISTERED NURSES Opporlunilies available 01
415-bed hospilal in Medical-Surgical, Labor and
Del ivery, I ntensive Care, Operating Room and Psv-
chictl y. No rotation of shift, good salary, evening
and night differentials, liberal fringe benefits
Temporary living accommodations available. Apply:
Miss. Dolores Merrell, R.N., Personnel Director, Queen
of Angels Hospilal, 2301 Bellevue Aevnue, Los
Angeles 26, California. 15-5-3G
REGISTERED NURSES - SAN FRANCISCO Children's
Hospilal and Adull Medical Cenler hospilal for men
women and children. California registration required
Opportunities in all clinical areas. Excellent salaries.
differentials for evenings and nights. Holidays, vaca-
tions, sick leave, life insurance, health insurance ond
employer-paid pension-plan. Applications and details
furnished on request. Contact Personnel Director, Chil-
dren's Hospital, 3700 California Street, San Francisco
18, California_ 15-5-4
RED CROSS
IS ALWAYS THERE
WITH YOUR HELP
FEBRUARY 1967
UNITED STATES
.tegilt.red Nur..., Career satisfaction, interest and
;,rofessional growth unl imited in modern, JCAH. ce-
.redited 243-bed hospital. Located in one of Cahfor-
'lia's finest areas, recreational, educational and cul-
tural advantages are yours as well as wonderful
year-round climate. If this combination is what
iou're looking for, contact us now!Staff nurse en-
trance salary above $500 per monthi increases to
$663 per month; supervisory positions at highest
rates. Special area and shift differentials to $50 per
month paid. Excellent benefits include free health
and life insurance retirement, credit union and liberal
personnel policies. Professional staff appointments
available in all clinical areas to those eligible for
California licensure. Write today: Director of Nursing.
Eden Hospital. 20103 Lake Chabot Road, Castro VaI-
leI', California. 15.5-12
REGISTERED NURSES: Mount Zion Hospital and Me-
dical Center'. increased salary scales now double our
attraction for nurses who find they can afford to live
6;Jy the Golden Gate. Expansion has created vacQnc
es
for staff and specialty assignments. Address enquiry
to: Personnel Department, 1600 Divisadero Street. San
Francisco, Cal ifornia 9411 S. An equal opportunity em-
ployer. 15.5.4 C
Regi.tered Nurse. for 303-bed modern hospital. Po.
sitlons available - All services, no .hift rotation.
Liberal benefits, advancement opportunities, educa-
ONTARIO HYDRO
requires
REGISTERED NURSE
with
Public Heolth Nursing Cerfificafe. Inferest-
ing and responsible position locofed in
Norfhern Ontario Hydro Colony.
For further details please
write to:
Nursing Supervisor
ONTARIO HYDRO
620 University Avenue
Toronto 2, Ontario
SCHOOL OF NURSING
PLUMMER MEMORIAL PUBLIC
HOSPITAL
SAULT STE. MARIE, ONTARIO
Invites applicants for:
1. Medical-Surgical Instructor
2. Medical Instructor
250-bed non-sectorian General Hospital
with enrolment of BO students. Salary
commensurote with qualifications.
Apply to:
Principal,
SCHOOL OF NURSING.
:EBRUARY 1967
I I
I I
UNITED STATES
UNITED STATES
tional opportunities in area. equal opportunity
employer. Apply: Director of Nursing Service. Kaiser
Foundation Hospitals. San Francisco 15, California.
Phone (JO 7.4400) 15.5-57
hours from Lake Tahoe. Starting salary $51O/m.
with differentials. Apply: Director of Nunes, Mem-
orial Hospital, Woodland, California. 15-5-498
Wanted - General Duty Nur.el. Applications now
being taken for nursing positions in a new addi-
tion to the existing hospital including surgery, cen-
tral sterile and supply, general duty. Salary $425
per month plus fringe benefits. Contact: Director of
Nurses, Alamosa Community Hospital Alamosa,
Colorado. 15-6-1
Regiltered Nursel - California. Expanding, accredit.
ed 303.bed hospital in medical center of Southern
California. University city. Mountain ocean resort
area. Ideal year-round climate, smog free. Starting
salary $6,300. With experience, $6,600. fringe bene-
fits, shif, differential, initial housing ollowance.
Wide variety rentals available. For details on Cali-
fornia License and Visa, write: Director of Nursing,
Cottage Hospitol, 320 W. Pueblo Street, Santa Bar-
bara, California 93105. 15-5-39 A
STAff NURSES: Needed to staff present fully accredit.
ed hospital and new facility to open December 1967.
All services and shifts available. Good salaries and
fringe benefits. Will pay transportation to and from.
Minimum one year contract. For particulars concerning
hospital and community write: L. E. Thompson, Ad-
ministrator, or V. Jenkins, Director of Nursing, Scioto
Memorial Hospitol, Portsmouth, Ohio. 15.364
REGISTERED NURSES - General Duty for 84-bed
JCAH hospital 1 1 a houri from San Francisco, 2
WI!
.
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:[i
BOX 1311 C
DOROTHY EASLEY, R.N. - Nurse Recruitment Officer
1200 North State Street
Los Angeles, Californio 90033
Telephone 213 225-3115
Are you looking for career nursing opportunities?
Do you want more training?
Do unusual services appeal to you?
Then you will want
more information about our hospital
We are a university teaching hospital
for two schools of medicine.
We have over 200 internes, 300 residents
and a full time medical staff.
We are one of the world's
largest medical centers.
Starting Salary-$560.00/ month
. Credit for degree
. Shift differential
. Credit for experience
Outstanding Promotional Opportunities
Assistant Head Nurse or Charge Nurse
Head Nurs.e
Clinical Specialist; Teaching Assistant; Instructor
Coronary Care Unit; P.AR., Intensive Care Units;
Chest Surgery; Jail; Premature Center; Admitting;
General Medicine; O.R.; Diabetic Service; Neurosurgery;
Metabolic Research; Dermatology; Orthopedics; Eye; Rehab;
You name it - We have it I
THE CANADIAN NURSE 61
UNITED STATES
G.n.ral Duty Staff Nur... for 450.bed fully approved
teaching hospital. Top salaries with differential for
evening and night duty. High increments. 4Q-hour
week, paid vacation based on length of service, 8 paid
holidays per year. Accumulative sick plan. Com.
prehensive hospitalization plan. Excellent pension
plan. Orientation and dynamic inservice program.
Nurses' Association (A.F.L.) governs hours, salaries
and working conditions. Registration ta work in
California required. Address applications to: Chief
Nurse, Southern Pacific Memorial Hospital, 1400 Fell
Street. Son francisco. California 94117. 15.5-6 D
ATTENTION GENERAL DUTY NURSES. 297-bed fully
accredited County Hospital located 2 hrs. drive from
San Francisco, ocean beaches, and mountain resorts in
modern and progressive city of 40.000. 40 hr. 5
day wk., pd. vocation, pd. holidays, pd. sick leave,
retirement plan, social security, and insurance plan.
Accommodations in Nurses' Home, meals at reasonable
rates. uniforms laundered without charge. Stort $530
to $556 mo. depending on experience plus .hift and
service differentials. Merit increases to $644 mo. Must
be eligible for Calif. Registration. Write Director of
Nursing. Stanislaus County Hospital. 830 Scenic
Drive, Modesto, California. 15-5-42 B
Nurs.. for new 75-bed General Hospital. Re.ort
area. Ideal climate. On beautiful Pacific ocean.
Apply to: Director of Nur.... South Coast Com-
munity Hospital. South Laguna, California. 15-5-50
I I
UNITED STATES
Stoff Duty pa.itian. (Nur...) in private 403-bed
hospital. Liberal personnel policies and salary. Sub.
stantial differential for evening and night duty.
Write: Personnel Director, Hospital of The Good
Samaritan. 1212 Shatto Street. Los Angeles ] 7,
California_ 15-5-31>
NURSE TEAM LEADER POSITIONS in new 372-bed,
fully accredited. General Hospital in resort area. $461
p.r month days and $485 per month evening and
night shift. Liberal fringe benefits. For descriptive bro-
chure and pol icies write: L. Sims, North Miami Gene-
ral Hospital. 1701 NE t27th Street. North Miami.
florida. 15-10-2 A
REGtSTERED NURSES: for 75-bed air conditioned
hospital, growing community. Starting salary $330-
S365/m, fringe benefits, vacation, sick leave, holi-
days, lif. insurance, hospitalization. 1 meal furnish-
ed. Write: Administrator, Hendry General Hospital,
Clewiston. florida. J 5-10-1
G.n.ral Duty Nur.e. - Pre.ent hospital 55-bed.
with new 75-bed ho.pital to oper. April. I, 1965.
Located on Lak. Okeechobee near west Palm Beach.
Liberal personnel policies, 40-hr. wk., bonus at end
of fir.t year. Minimum starting salary $380. with
differential for evenings and nights. Apply: Director
of Nursing Service. Glade. G.neral Hospital. P.O.
Box 928. Bell. Glade. florida. 15-10-3
"
NIGHT NURSE?
University Hospital is pleased to announce that starting pay for night
nurses now ranges from $30.00 to $33.00 per shift ($7,830 to $8,613
for an annual starting salary)-depending on education and experience.
After 4 years service, night nurse salaries range up to $9,396.00
per year. The base pay for permanent evening and rotating tours
has also been increased plus excellent University Staff benefits are
offered to all nurses.
University Hospital has a Service Department which assigns trained
personnel to handle paperwork and other non-nursing chores,
relieving our nurses for patient care exclusively.
Ann Arbor is nationally known as a Center of Culture with emphasis on
art, music and drama-and recognized as an exciting and desirable
community in which to live.
Write to Mr. George A. Higgins, A6001, University Hospital,
University of Michigan Medical Center, Ann Arbor, Michigan for
more information, or phone collect (313) 764.2172.
We are an Equal Opportunity Employer
UNIVERSITY OF
MEDICAL CENTER.
MICHIGAN
ANN ARBOR
62 THE CANADIAN NURSE
NURSES. Regi.tered, for modern 360-bed hospital.
Op
nings available in all areas, medicine-surgery,
delivery room, nursery, and postpartum. Near Wayne
State University, and an integral part of the new
Medical Center. Salary $550 to $635 per month
plus differential for afternoon and night. Premium
pay for weekends. Good fringe benefits including
Blue Cross and Life Insurance. Apply: Personnel
Director, Hutzel Hospital formerly Woman's Hospital),
432 East Hancock. Detroit, Michigan 48201. 15-23-1 f
OPERATING ROOM NURSE
Preference given posfgraduofe and! or ex-
tensive fraining.
for 270 bed ocufe General Hospitol in the
interior of British Columbio.
Apply to:
Director of Nursing
ROYAL INLAND HOSPITAL
Kamloopsr B. C.
DIRECTOR OF NURSING
The Solem Chrisfion Sanitorium Associo-
fion Inc.. which pions to open if's 3Q-bed
privote Psychiatric Hospital near Toronto
in 1968. invifes opplicofions for the obove
posifion. Appoinfmenf will be mode short-
ly to allow Director fo porficipote in
planning ond to toke speciol training if
odvisoble.
Apply to:
Rev. J. VanHarmelen r
Box 33, R.R. No. 2r
Whitby, Ontario.
REGISTERED NURSES
For 011 services including Operofing ond
Delivery Room.
Hospifol ropidly exponding fo 450 bed..
Solory $502 to $590 wifh shift, week-end
ond Chorge Nurse differentiol.
Write to Nursing Ollice
ST. JOHN HOSPITAL
22101 Moross Road
Detroit, Michigan 48236
or Telephone: 881-8200
(4-11.24)
FEBRUARY 1967
I II
OPPORTUNITY FOR
GROWTH
CHANGE
SPECIALIZA TION
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TORONTO GENERAL HOSPITAL
Large centrally located University Teaching Hospital
. CONTINUE YOUR PROFESSIONAL GROWTH
Planned orientation programme
Continuing in-service programmes
OpportunitIes of a research and teaching hospital
. BROADEN EXPERIENCE
Posifians available:
General medicine - Obstetrics - Operating Room
General Surgery - Gynaecology - Recovery Room
Specialty units and intensive care - Cardiovascular
Respiratory.- Neurosurgery
. ENJOY ADVANTAGES OF LIBERAL PERSONNEL POLICIES
Excellent patient core facililres
Salaries ICaled to qualifications and experience
3 weeks vocation, statutory holIdays. cumulative sick leave
-. Life Insurance, hospitalization, retirement programme
- Umfarms laundered free
REGISTERED NURSES
Lutheran General Hospital, Park Ridge, Illinois is a
new 587-bed General Hospital, located in a pleasant
suburb of Chicago.
The hospital is modern with a wide range of services
to patients, including Hyperbaric Oxygen Unit. Low-
cost modern housing next to the hospital is available.
The hospital is completely air-conditioned.
Annual beginning salary is from $6,000 plus shift
differential pay. Regular salary increments at six
months of service and yearly thereafter. Sick leave
and other fringe benefits are also available.
Write or call collect:
Director of Nursing Services
LUTHERAN GENERAL HOSPITAL
PARK RIDGE r ILLINOIS 60068
Telephone: 692-2210 Ext. 211
Area Code: 312
:EBRUARY 1967
For additional information, write:
Director of Nursing
TORONTO GENERAL HOSPITAL
101 College Street, Toronto 2, Ontario
t
II
SCARBOROUGH CENTENARY HOSPITAL
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Invites Applications For:
- ASSISTANT DIRECTOR
OF ADMINISTRATIVE NURSING
- SUPERVISORS OF CLINICAL AREAS
-0. R. SUPERVISOR
- CASEROOM AND EMERGENCY STAFF
This modern 750-bed hospifal, scheduled to open in the Summer of
1967, is fully equipped with the latesf facilities to assist personnel
in patient care and embraces the most m
ern concepts
f team
nursing. Excellent personnel policies are avaIlable. Progres.Slve staff
and managemenf development programs offer th
maxImum op-
portunities for those who are inferested. Salary IS commensurate
with experience and ability.
For further information, please direct your enquiries to:
Director of Nursing Service,
SCARBOROUGH CENTENARY HOSPITAL
Post Office Box 250, West Hill, Ontario
THE CANADIAN NURSE 63
OSHA W A
GENERAL HOSPITAL
GENERAL DUTY NURSES FOR
ALL DEPARTMENTS
Starting salary for Ontario Regis-
tered nurses $400 with 5 annual
increments to $480 per month.
Credit for acceptable previous
service - one increase for two
years, two increases for four or
more years.
Non-registered - $360.00
Rotating periods of duty - 3
weeks vacation - 8 statutory
holidays.
One day's sick credit per month
beginning in the 7th month of
service cumulative to 45 days.
Pension Plan and Group Life
Insurance - Hospital pays 50%
of Medical, Blue Cross and Hos-
pital Insurance premiums.
Apply to:
Director of Nursing
OSHAWA GENERAL HOSPITAL
Oshawa, Ontario
ST. JOSEPH'S
HOSPIT AL
HAMIL TON.
ONTARIO
A modern, progressive hospital,
located in the centre of Ontario's
Golden Horseshoe-
invites applications for
GENERAL STAFF
NURSES
and
REGISTERED
NURSING ASSISTANTS
Immediate openings are avail-
able in Operating Room, Psy-
chiatry, Intensive Care - Coro-
nary Monitor Unit, Obstetrics,
Medical, Surgical and Paediatrics.
For further information write to:
THE DIRECTOR OF NURSING
ST. JOSEPH'S HOSPIT At
Hamilton, Ontario
64 THE CANADIAN NURSE
m
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UNIVERSITY OF ALBERTA
SCHOOL OF NURSING
Invites applications
for instructors in:
· Medical-Surgical Nursing
· Paediatric Nursing
for four-year basic degree
programme
and
· Nursing Service Administration
for post-basic degree programme
Effective date of employment:
July, 1967
Salary in accord with University af Alber-
ta salary schedule and commensurate
with qualificafians and experience. Mas-
ter's degree or higher preferred.
Apply to:
RUTH E. McCLURE
DIRECTOR,
SCHOOL OF NURSING
UNIVERSITY OF ALBERTA
EDMONTON, ALBERTA
STAFF NURSE POSITIONS
Salary Range $482-$620
with maximum starting $539 on day shift,
$592 evening and/ar night shiffs. Credit
given for educatian and/or experience.
Opportunity fo gain knowledge and skill
in a specialized cancer research hospital.
Regisfration in Texas required. Excellenf
personnel benefifs include: 3 weeks vaca-
tion, halidoys. cumulafive sick leave.
laundry of uniforms furnished. refirement
and Social Securify programs, Hospitaliza-
tian, life and Disabilify Income Insurance
available. Equal opportunity employer.
For applicatian and additional informatian
Write ta:
Personnel Manager
THE UNIVERSITY OF TEXAS
M.D. ANDERSON HOSPITAL AND
TUMOR INSTITUTE
Texas Medical Center
Houston, Texas 77025
ASSISTANT DIRECTOR
OF NURSING
Applications are invited for the
above position in a fully ac-
credited 163-bed General Hos-
pital in beautiful Northern On-
tario.
Desirable qualifications should
include B.S.N. Degree with ex-
perience in supervision.
For further information,
Write to:
Director of Nursing
KIRKLAND and DISTRICT HOSPITAL
Kirkland Lake, Ontario.
ONTARIO SOCIETY
FOR
CRIPPLED CHILDREN
requires
. Camp Directors
· General Staff Nurses
. Registered Nursing Assistants
for
FIVE SUMMER CAMPS
located near
OTTAWA COLLINGWOOD
LONDON - PORT COLBORNE
KIRKLAND LAKE
Applicafians are invifed from nurse.s in-
ferested in the rehabilitation of physically
handicapped children. Preference given ta
CAMP DIRECTOR applicants having super-
visary experience and ta NURSING ap-
plicants wifh paediatric experience
Apply in writing to:
Miss HELEN WALLACE, Reg. N.,
Supervisor of Camps,
350 Rumsey Road,
Toronto 17, Ontario
FEBRUARY 1%7
...
This
.
IS a
little Eskimo boy
Sometime during the next year.
he might fall and hurt himself-
or get measles or pneumonia.
..
He will need the care of a nurse.
..
A good nurse.
Maybe you?
Registered hospital and public health nurses, certified nursing assistants,
lor lurther inlormation write to:
MEDICAL SERVICES, DEPARTMENT OF NATIONAL HEALTH AND WELFARE, OTTAWA, CANADA.
DIRECTOR OF NURSING
Applications are invited
lor the
POSITION OF DIRECTOR OF NURSING
The Director of Nursing will be responsible for
the administration of all nursing services within
the hospital. The hospital currently operates
375 beds and is undergoing extensive moderni-
zation and expansion costing $3,750,000. There
is a furnished apartment available at a mini-
mum rental. A 140 student School of Nursing
housed in a modern residence and operated
by the hospital is the responsibility of a Director
of Nursing Education.
Address enquiries to:
DOUGLAS M. McNABB, Administrator
McKELLAR GENERAL HOSPITAL
Fort William, Ontario
FEBRUARY 1967
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THE SCARBOROUGH
GENERAL HOSPITAL
Invites applications from General Duty Nurses.
Excellent personnel policies. An active and stimulat-
ing In-Service Education and Orientation Programme.
A modern Management Training Programme to as-
sist the career-minded nurse to assume managerial
positions. Salary is commensurate with experience
and ability. We encourage you to take advantage
of the opportunities offered in this new and expand-
ing hospital.
For lurther inlormation write to:
Director of Nursing
SCARBOROUGH GENERAL HOSPITAL
Scarborough, Ontario
THE CANADIAN NURSE 65
THE HOSPITAL
FOR
SICK CHILDREN
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OFFERS:
I. Satisfying experience.
2. Stimulating and friendly en-
vironment.
3. Orientation and In-Service
Education Program.
4. Sound Personnel Policies
5. liberal vacation.
APPLICATIONS FOR REGISTERED
NURSING ASSISTANTS INVITED
For detailed information
please write to:
The Assistant Director
of Nursing
AUXILIARY STAFF
555 University Avenue
Toronto, Ontario, Canada
66 THE CANADIAN NURSE
HUMBER MEMORIAL HOSPITAL
HOSPIT AL -
Newly expanded 350-bed hospital. Progressive patient care con-
cept.
SALARY -
General Staff Nurses (Currently Registered in Ontario) $400.00 -
$480. - 5-increments.
Registered Nursing Assistants (Currently Registered in Ontario)
$295.00 - $331.00, - 3 increments.
HOUSING -
Furnished apartments available at subsidized rates.
JOB SATISFACTION -
High quality patient care and friendly working environment. We
appreciate our personnel and encourage their professional develop-
ment.
You are invited to enquire concerning employment opportunities to:
Director of Nursing
HUMBER MEMORIAL HOSPITAL
200 Church Street, Weston, Ontario
Telephone 249-8111 (Toronto)
CALGARY GENERAL HOSPITAL
requires immediately
REGISTERED GENERAL DUTY NURSES
This is a modern 1,000-bed hospital including a new
200-bed convalescent-rehabilitation section. Benefits
include Pension Plan, sick leave, and shift differen-
tial plus a liberal vacation policy and salary range
$360 - $420 per month commensurate with training
and experience.
Apply to:
Director of Nursing Service
CALGARY GENERAL HOSPITAL
Calgary, Alberta
FEBRUARY 1967
What does
Methodist Hospital
have to offer me?
At the Methodist Hospital, where research is a part
of progress, a nursing career takes on new horizons -
rich in meaning and professional satisfaction.
If you're looking for the chance to be the nurse
you've always dreamed of - coming to the world
famous Methodist Hospital can be an adventure -
almost like stepping into the future - splendid
facilities, so much advance equipment and
everywhere the newest medical and patient care
techniques are in use.
Some of the best aspects of nursing at METHODIST
are as old as medicine itself - there is a spirit of
kindness and consideration, and emphasis on patient
care, that make this a hospital where nursing is
satisfying and rewarding, day by day.
Methodist Hospital is right in the center of the world's
great Medical, Research and Educational complexes.
HOUSTON is an exciting city - rodeo and opera,
pro.football and the famous Alley Theatre, water sports
and beaches an hour or less away, the Houston
Symphony and the Astrodome!
A Few Quick Facts: We're affiliated with Baylor
University College of Medicine and associated with
Texas Woman's University College of Nursing.
New $9'f.! million Cardiovascular and Orthopedic
Research Center will open soon. Our Inservice
Education Department gives you thorough
orientation, and continued instruction in new
concepts and techniques. You'll find every
encouragement to broaden your skills,
including tuition assistance in obtaining
further education in nursing.
...
Send for Your Colorful Informative Illustrated
Brochure. . . to learn about Methodist Hospital,
Houston, positions available, salary and employment
benefits, tuition allowance, complimentary room
accommodation and our Nurse Specialist Programs.
Write, call or send coupon, Director of Personnel,
The Methodist Hospital, Texas Medical Center,
Houston, Texas 77025
....j
r-------------------------------------ì
I Director of Personnel, THE METHODIST HOSPITAL, Texas Medical Center, Houston, Texas 77025 I
I Please send me your brochure about nursing opportunities at THE METHODIST HOSPITAL-Texas Medical Center I
I I
I Name I \
I Address I
I I
I City State Zip Code I
L_____________________________________
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UNIVERSITY
OF ALBERTA
HOSPITAL
Positions are available in our
rapidly expanding Medical Cen-
tre situated on a growing Uni-
versity campus. All service in-
cluding renal dialysis, coronary
intensive care and cardiac surg-
ery offer opportunities for ad-
vancement.
Apply to:
Director of Nursing
UNIVERSITY OF ALBERTA
HOSPITAL
Edmonton, Alberta
REGISTERED NURSES
for General Duly
In modern 20-bed hospital locat-
ed in thriving northwestern On-
tario community. Starting salary
$335 minimum to $400 maxi-
mum for three years' experience.
Board and room in modern
nurses' residence is supplied at
no charge. Excellent employee
benefits and recreational facili-
ties available. Further particulars
on request. Apply giving full
details of experience, age, avail-
ability, etc. to:
Employment Supervisor
MARATHON CORPORATION
OF CANADA LIMITED
EBRUARY 1967
Marathon, Ontario
OPERATING ROOM
SUPERVISOR
Required for 270-bed General
Hospital with construction of a
new hospital due to completion
in 1967, increasing the bed ca-
pacity to 450. Included in the
new hospital will be the most
modern operating room complex
based on the Friesen Concept of
material and equipment supply.
Excellent fringe benefits with
generous sick leave, four weeks
vacation and contributory pen-
sion plan.
For further information write:
Director of Nursing Service
BELLEVILLE GENERAL HOSPITAL
Belleville, Ontario.
THE CANADIAN NURSE 67
ONTARIO soclm
FOR
CRIPPLED CHILDREN
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Invites applications from Public
Health Nurses who have at least
2 years experience in general-
ized public health nursing, pre-
ferably in Ontario.
INTERESTING AND VARIED
PROFESSIONAL SERVICES
IN AN EXPANDING PROGRAM
INCLUDE:
. an opportunity to work direct-
ly with children, their parents,
health and welfare agencies,
and professional groups
. participation in arranging
diagnostic and consultant cli-
nics
. assessing the needs of the
individually handicapped child
in relation to services provided
by Easter Seal Clubs and the
Society.
Attractive salary schedule with
excellent benefits. Car provided.
Pre-service preparation with sa-
lary.
Apply in writing to:
Director, Nursing Service,
350 Rumsey Road,
Toronto 17, Ontario
68 THE CANADIAN NURSE
Registered Nurses
AND
Registered
Nursing Assistants
For 300-bed Accredited General
Hospital situated in the pictur-
esque Grand River Valley. 60
miles from Toronto.
Modern well-equipped hospital
providing quality nursing care.
Excellent personnel policie5.
For further information write:
Director of Nursing Service
SOUTH WATERLOO
MEMORIAL HOSPITAL
Galt, Ontario
REGISTERED NURSES
250-bed General Hospital, ex-
panding to 400, located in San
Francisco, California. Positions on
all shifts for nurses in Intensive
Care Unit, Operating Room, and
General Staff Duty. Salary range
effective April 1967, $600-$700.
Health and life Insurance, Retire-
ment Program - all hospital
paid. liberal holiday and vaca-
tion benefits. Accredited medical
residencies in Medicine, General
Surgery, Neuro Surgery, Ortho-
pedics, and Plastic Surgery.
For further information write to:
Miss Lois Jann,
Director of Nursing
FRANKLIN HOSPITAL
14th and Noe Streets,
San Francisco, California
THE
NORTHWESTERN
GENERAL
HOSPIT AL
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THE HOSPITAL-
Fully accrediled
Progressive 150 bed hospital
Planned expansion to 400 beds
10 minutes to downtown Toronto.
YOUR PROFESSIONAL GROWTH
Planned orientation programme
Continuing inservice education.
BENEFITS INCLUDE-
3 weeks vacation
8 slatutory holidays
Cumulalive sick leave
Group life insurance
Hospitalization
40 hour week.
HOUSING -
Furnished apartmenls al reduced rates
For information contact:
Director of Nursing
NORTHWESTERN
GENERAL HOSPITAL
2175 Keele St.,
Toronto 15, Onto
FEBRUARY 196"
PALO ALTO-STANFORD
HOSPITAL CENTER
Located on the beautiful campus of Stanford University in Palo Alto, California.
,
,
,
--
.,
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"We invite you to join our professional staff and to gam unparalled experiences m
nursing."
For additional information-
NAME:
ADDRESS:
CITY:
SERVICE DESIRED:
Return to: PALO ALTO-STANFORD HOSPITAL CENTER
Personnel Department
300 Pasteur Drive
Palo Alto, California
STATE:
REGISTE RED NURSES
REGISTERED NURSING
ASSIST ANTS
REQUIRED FOR
ST. MARY'S HOSPITAL
TIMMINS, ONTARIO
MODERN - 200 BED HOSPITAL
EXCELLENT PERSONNEL POLICIES
PLEASANT TOWN OF 30.000
WIDE VARIETY OF SUMMER
AND WINTER SPORTS -
SWIMMING, BOATING,
FISHING. GOLFING, SKATING,
CURLING, TOBOGGANING,
SKIING AND ICE FISHING.
Apply to:
Director of Nursing Service
ST. MARY'S HOSPITAL
Timmins, Ontario
EBRUARY 1967
VICTORIA HOSPIT At
LONDON. ONTARIO
Modern 1.000-bed hospital
Requires
Registered Nurses for
all services
and
Registered
Nursing Assistants
40 hour week - Pension plan
- Good salaries and Personnel
Policies.
Apply:
Director of Nursing
VICTORIA HOSPIT At
London, Onto
ST. JOSEPH'S HOSPITAL
TORONTO, ONTARIO
REGISTERED NURSES
and
REGISTERED
NURSING ASSISTANTS
lOO-bed fully accredited hospital provides
experience in Operating Room. Recovery
Room, Infensive Care Unit. Pediatrics
Orthopedics, Obstetrics. General Surgery
and Medicine.
Orientation and Active Inservice program
for all staff.
Salary is commensurote with preporafion
and experience.
Benefits include Canada Pension Pion,
Hospital Pension Plan, Group Life Insu-
rance. Sick leave - 12 days after One
year, Onfario Hospital Insuronce - 50%
payment by hospital.
Rotafing Periods of duty - 40 hour week,
8 statufory holidays - annual vocotion
3 weeks after one yeor_
Apply:
Assistant Director of
Nursing Service
ST. JOSEPHrS HOSPITAL
30 The Queensway
Toronto 3, Ontario
THE CANADIAN NURSE 69
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YORK COUNTY HOSPITAL
NEWMARKET. ONTARIO
HOSPITAL:
A newly expanded 257 bed hospital wifh such progressive
patient care concepts as a 12-bed LCU., 22.bed psychiatric
ond 24-bed self care unif.
IDEAL LOCATION:
45 minutes from downtown Toronfo, 15-30 minutes from
excellenf summer ond winfer resort oreas.
SALARIES:
Registered Nurses: $372-$447 per month.
Registered Nursing Assistants: $277-$310 per month.
BENEFITS INCLUDE:
Furnished apartments, medical and hospital insurance. group
life insurance. pension plan, 40 hour week.
Please address all enquiries to:
Director of Nursing
YORK COUNTY HOSPITAL
596 Davis Drive
Newmarket, Ontario
ADDITIONAL CLINICAL TEACHERS
required
to assist in Developing New Curriculum and a
Regional School.
School of Nursing Building is New
and well equiped.
Salaries and Fringe Benefits at Metropolitan level.
Qualifications - B.Sc.N.
or
Diploma in Nursing Education
GENERAL STAFF NURSES
Required for all Services
Salaries and Fringe Benefits at Metropolitan level
Apply to:
DIRECTOR OF NURSING
BRANTFORD GENERAL HOSPITAL
Brantford. Ontario
70 THE CANADIAN NURSE
MAIMONIDES HOSPITAL
AND HOME FOR THE AGED
AN OPPORTUNITy....
A CHALLENGE....
A NEW EXPERIENCE....
SUPERVISORS, STAFF NURSES, NURSING
ASSISTANTS, INSTRUCTORS, PSYCHIATRIC
NURSE:
We invite you to join the nursing staff of New Mai.
monides.
LIBERAL VACATION HEALTH AND
PENSION PLANS _ SALARIES COM-
MENSURA TE WITH RECOGNIZED SCALES
Apply to:
DIRECTOR OF NURSING
5795 Caldwell Avenue
Montreal 29, Quebec
THE ST. CATHA RINES
GENERAL HOSPITAL
A modern 500-bed hospital located in the heart
of the beautiful Niagara Peninsula, within
easy travel distance from Buffalo, Hamilton
and Toronto, invites applications from: Gener-
al StaH Nurses.
Pleasant working conditions. Excellent per-
sonnel policies.
Apply:
The Director of Nursing Service
THE ST. CATHARINES
GENERAL HOSPITAL
St. Catharines r Ontario
FEBRUARY 196:
DIRECTOR
OF SCHOOL OF NURSING
Applications are invited for the above position in a
School of Nursing intending to revise programme in
Fall of 1967 to a two year programme with a third
year of experience in hospital nursing service. The
School of Nursing is a new self-contained educational
building, opened in 1964, with enrollment of ap-
prox imately 140 students.
Trent University is situated in Peterborough.
Minimum requirement - Bachelor's Degree. Salary
will be commensurate with qualifications and ex-
perience.
For further details apply to:
Chairman of Nursing Education Committee,
PETERBOROUGH CIVIC HOSPITAL
Peterborough r Ontario
KOOTENAY LAKE GENERAL HOSPITAL
invites applications for the position of
DIRECTOR OF NURSING
The positian involves administration of the patient care services of
a leo-bed modern, accredited general care hospital with medical,
surgical, obstefrics and paediatric services. Nursing service staff
comprises 38 graduafe nurses, 20 procfical nurses and orderlies and
5 p.n. trainees.
The Direcfor of Nursing would be directly responsible to fhe
Administrafor.
Graduation from an approved School of Nursing essential with
experience or preparation in patient care administration desirable.
location of the hospital is Nelson in the Kootenay lake Regian
of Southeasfern British Columbia, centre of Notre Dome University,
Kootenay School of Art and B.C. Vocational Training School. It is
an area of stable economy, temperate climafe with varied edu-
cafional, culfural, commercial, industriol. administrafive and resort
activity.
Please direct enquiries or applications stating
experience, training and references to:
Administrator,
KOOTENAY LAKE GENERAL HOSPITAL
3 View Street,Nelson, B. C.
EBRUARY 1967
MORRISTOWN MEMORIAL HOSPITAL
MORRISTOWN, NEW JERSEY
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Morristown Memorial is a modern, full-service, 355-bed regional
hospital center with excellent opportunities for specialization and
advancement in all types of positions within the general and spe-
cialty fields. All services are accredited. Our planned orientation
and continuing in-service training programs are managed by a full-
time director and supervised by physicians, nurses, and specialists
in related fields. Three nearby universities offer opportunity for
advanced study.
Here at Morristown Memorial you can further your professional
development while enjoying the advantages of life in a friendly
suburban community only 30 miles away from the heart of New
York City. Attractive, low.cost apartments are available within our
own buildings located but a few steps from the Hospital's entrance.
Minimum starting salaries are:
$120.00 weekly (day) . .......... $520.00 monthly
$136.15 weekly (3-11 or 11-7) .... $590.00 monthly
In addition, we provide a liberal program of fringe benefits.
You advance to supervisory positions on merit; promotions
are made from within.
New Jersey has no state income tax.
For full information concerning nursing opportunities, write to:
Miss Ruth C. Anderson, R. N., Asst. Administrator
Morristown Memorial Hospital, Morristown, New Jersey
THE CANADIAN NURSE 71
WOODSTOCK GENERAL HOSPITAL
Requires
GENERAL STAFF NURSES
ALL DEPARTMENTS
and
O.R. TECHNICIANS
Apply.
Director of Nursing
WOODSTOCK
GENERAL HOSPITAL
Woodstock, Ontario
McKELLAR GENERAL HOSPITAL
requires
Registered Nurses for general Staff. The
hospital is friendly and progressive.
It is now in the beginning stages of a
$3,500,000 program of expansion and
renovation.
- Openings in all services.
- Proximity fo lakehead
ensures opportunity for
education.
University
furthering
For full particulars write to:
Acting Director
of Nursing Service
McKELLAR GENERAL HOSPITAL,
Fort William, Ontario.
ST. JOSEPH'S HOSPITAL
SCHOOL OF NURSING
Hamilton, Ontario
r
uires
CLINICAL INSTRUCTORS in all Nursing
areas. Well-equipped, modern School of
Nursing. Student enrolment OYer 300.
Modern, progressiye, SOO-bed Hospital.
Salary commensurate with preparation
and experience.
For further details, apply:
DIRECTOR OF NURSING
72 THE CANADIAN NURSE
PORT COLBORNE
GENERAL HOSPITAL
PORT COlBORNE, ONTARIO
ST AFF NURSES
required
For 166-bed hospital within easy driving
disfonce of American and Canadian me-
tropolitan centres. Consideration given for
previous experience obtained in Canada.
Completely furnished apartment-style resi-
dence, including balcony ond swimming
pool facing lake, adjacent fo hospital.
Apply:
Director of Nursing
GENERAL HOSPITAL
Port Colborne,Ontario
REGISTERED NURSES
For new IOO-bed General Hospital in
resort town of 14,000 people, beautifully
located on shores of lake of fhe Woods.
Three hours' fro vel fime from Winnipeg
with good transportation available. Wide
variety of summer and winter sports-
swimming, boating, fishing, golfing, skat-
ing, curling, tobogganing. skiing and ice
fishing.
Salary: $372 for nurses registered in
Ontario with allowance for experience.
Residence available. Good personnel poli-
cies.
Apply to:
DIRECTOR OF NURSING
KENORA GENERAL HOSPITAL
Kenora, Ontario
OTTAWA CIV1C HOSPITAL
OTTAWA, ONTARIO
This modern 1087.bed teaching hospital
requires:
REGISTERED NURSES
FOR All SERVICES INCLUDING
OPERATING ROOM AND PSYCHIATRY
Excellent salaries, personnel policies and
Fringe benefits are availoble.
Apply in writing to:
B. JEAN MILLIGAN, Reg. N., M.A.
Assistant Director
ST. JOSEPH'S HOSPITAL
lONDON. ONTARIO
Teaching Hospital, 600 beds. new facilities
requires :
TEACHERS
REGISTERED NURSES
REGISTERED NURSING ASSISTANTS
For further information apply :
The Director of Nursing
ST. JOSEPH'S HOSPITAL
London, Ontario
DIRECTOR OF NURSING
EDUCATION
Master's degree preferred; to conduct
basic nursing program and affilliafe pro-
gram
Apply to:
Director of Nursing,
CHILDREN'S HOSPITAL
OF WINNIPEG,
Winnipeg, Manitoba.
ST. THOMAS-ELGIN
GENERAL HOSPITAL
Requires
GENERAL STAFF NURSES
REGISTERED NURSING
ASSISTANTS
O. R. TECHNICIANS
Modern 395 bed, fully accredited General
Hospital opened in 1954, with School of
Nursing. Excellent personnel policies.
O. H. A. Pension Plan. Pleasanf progres-
sive industrial city of 22.500.
Apply:
Director of Nursing,
ST. THOMAS-ELGIN GENERAL
HOSPIT AL
St. Thomas, Ontario.
FEBRUARY 1967
OPERATING ROOM
SUPERVISOR
With Postgraduate Course in
Operating Room technique
and management
Required for a 375-bed fully
accredited General Hospital with
projected reconstruction program.
Salary based on qualifications
and experience.
Fringe benefits include hospital
and medical coverage, generous
sick leave, three weeks' vacation
and contributory pension plan.
For further information write:
Director of Nursing Service
METROPOLITAN
GENERAL HOSPITAL
Windsor, Ontario
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. . Good starting salary
. . In-service education
. . 12 paid sick days per year
. . Tuition refund program
. . Free life and
disability insurance
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125 West 41 St.
New York, N.Y. 10036
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Employer MfF
EBRUARY 1967
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THE WINNIPEG GENERAL HOSPITAL
i. Recruiting General Duty Nurse. for all Service.
SEND APPLICATIONS DIRECTLY TO
THE PERSONNEL DIRECTOR,
WINNIPEG GENERAL HOSPITAL
WINNIPEG 3, MANITOBA
DIRECTOR, SCHOOL OF NURSINC
Applications are invited
for the
POSITION OF DIRECTOR.
SCHOOL OF NURSING
;';.-
The Director will have complete charge of two-plus-one
diploma program with 360 students, adequate faculty,
new ultra-modern facility associated with 1000-bed
teaching hospital. Master's degree preferred. Considera-
tion will be given to candidate with Bachelor of Science
in Nursing Education degree and good leadership poten-
tial. Appointment will be made by July 1, 1967.
For further information. write to:
Chairman r Nursing Advisory Committee
c/o Nursing Office,
VICTORIA HOSPITAL
London, Ontario.
THE CANADIAN NURSE 73
REGISTERED NURSES
Staff posifions available in acute and
convalescent unit of large General Hospital
locafed in San Francisco Bay Area. Sfarfing
salary $550 fo $605 plus differenfial. Ex-
cellenf benefits.
Apply:
SEQUOIA HOSPITAL
Whipple and Alameda
Redwood City, California
222 BED GENERAL HOSPITAL
requires
STAFF NURSES
REGISTERED NURSING ASSISTANTS
Cornwall is noted for its summer and
winter sport areas, and is an hour and a
half from both Montreal and Ollawa.
Progressive personnel policies include 4
weeks vacatian. Experience and posf-basic
certificates are recognized.
Apply to:
Ass't. Director of Nursing
(service)
CORNWAll GENERAL HOSPITAL
Cornwall, Ontario
EVENING OR NIGHT
SUPERVISOR
For 70-bed active hospital locafed 70
miles East of Saskafoon. Salary com-
mensurafe wifh experience and qualifica-
fions. Excellent personnel policies.
Apply:
Director of Nursing Service
ST. ELIZABETH'S HOSPITAL
Humboldt, Saskatchewan
74 THE CANADIAN NURSE
RfGlSTERED NURSES
required for
B2-bed hospital. Situated in the Niagara
Peninsula. Transportation auisfance.
for salary rates and personnel policies,
apply to:
Director of Nursing
HALDIMAND WAR MEMORIAL
HOSPITAL
Dunnville, Ontario
DIRfCTOR OF NURSING
Applications are invifed for the above
position in a modern, 56-bed, fully ac-
credited hospital wifh expansion plans
under active sfudy. Nursing administrative
education and experience desirable.
Salary commensurafe with qualificafions.
Apply:
Mrs. M. Fearn, Executive Director
THE BARRIE MEMORIAL
HOSPITAL
Ormstown" Quebec
PETERBOROUGH CIVIC HOSPITAL
School of Nursing requires
INSTRUCTRESS (Nursing Arta)
INSTRUCTRESS (Medical.Surgical Area)
New self-contained educafion building for
school of nursing now open.
T renf Universify is situafed in Peferborough
For further information write to:
Director of Nursing
PETERBOROUGH CIVIC
HOSPITAL
Peterborough. Ontario
SCHOOL OF NURSING
WOODSTOCK GENERAL HOSPITAL
Requires the following Faculty
a) Psychiafric Teacher (One).
b) Medical and Surgical Teachers (Two).
Minimum requirement - B. Sc. N.
The above additional staff is required
for New Program.
Apply to:
Director of Nursing Education
WOODSTOCK GENERAL
HOSPITAL
Woodstock, Ontario
SOUTH PEEL HOSPITAL
COOKSVlllE, ONTARIO
A new 45Q-bed General Hospital, located
12 miles from fhe Cify of Toronto. has
openings fOr:
(1) GENERAL STAfF NURSES in all de-
partments;
(2) Registered Nursing Assistants in all
departments.
For information or application, write to.
Director of Nursing
SOUTH PEEL HOSPITAL
Cooksville, Ontario
SCHOOL OF NURSING
PUBLIC GENERAL HOSPITAL
Chatham, Ontaria
requires
INSTRUCTORS
Student Body of 130
Modern self-contained educafion building
Universify Preparation required with
salary differenfial for Degree.
For further information,
apply to:
Director r Nursing Education
FEBRUARY 196
THE HOSPITAL
FOR
SICK CHILDREN
1'r
J
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,
, II
,
\. l
YOU
Receive the advantages of:
1. Five-week orientation pro-
gram for new staff.
2. Ongoing in-service education
for nurses.
3. Extensive student education
program.
4. Research Institute.
APPLICATION FOR GENERAL
DUTY POSITIONS INVITED
For information contact:
THE DIRECTOR OF NURSING
555 University Avenue
Toronto, Canada
EBRUARY 1967
DIRECTOR
OF
REGIONAL SCHOOL
OF NURSING
"KIRKLAND LAKE"
Applications are invited for the
position of Director of a new
Regional School of Nursing to be
established in Kirkland lake with
an annual enrollment of 30
students encompassing five area
hospitals. An excellent opportu-
nity to develop a program from
the erection of the building to
operating the school.
Please direct enquiries to:
The Secretary of the Steering
Committee:
R. J. Cameron, Administrator,
KIRKLAND AND DISTRICT
HOSPITAL
Kirkland Lake, Ontario.
DIRECTOR
OF NURSING SERVICE
The Belleville General Hospital
requires a Director of Nursing
Service to be responsible for the
administration of all nursing ser-
vice activities.
The hospital presently has a ca-
pacity of 300 beds and will in-
crease to a total of 450 beds in
about one year, upon completion
of a construction programme.
The design incorporates a central
Supply Process Dispatch system.
Applicants should have a degree
in nursing service administration
as well as considerable expe-
rience in a similar position.
Applications and enquiries
should be addressed to:
Acting Administrator
BELLEVILLE GENERAL HOSPITAL
Belleville, Ontario.
OUR DIRECTOR
OF NURSING
needs you
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We're opening a brand new 120-
bed addition and we need your
help. We want our patients to
have the finest of care as well as
the finest of facilities. If you're a
professional nurse who's inter-
ested in enhancing your own
career as well as improving your
hospital's scope of care, we
need you.
h
PRESBYTERIAN HOSPITAL CENTER
ALBUQUERQUE, NEW MEXICO 87106
"Starting salary to $555 a month
--Expanding, progressive
500.bed hospital
--Personal orientation program
"liberal fringe benefits
"Continuing educational programs
"Airline travel paid
-*Two universities
--Growing metropolitan area
"Twenty minutes from nearby
mountain ski area
EQUAL OPPORTUNITY EMPLOYER
Mail coupon oreall collecI(505.243.9411, Ext. 219)
Mrs. Susan Dicke. Director of Nurse Recruitment
Presbyterian HospItal Cenler. Department B
Albuquerque. New MexIco 87106
Please mail me more information about nursing
at Presbyterian Hospital Centar and how I may
contribute to your patient care program.
Name
Address
City
State
School 01 Nursing
Year of Graduallon _Month
THE CANADIAN NURSE 75
GRADUATE NURSES
Eligible for registration in fhe
Province of Ontario.
Various posifions available os SUPER-
VISORS, HEAD NURSES, ond GENERAL
DUTY NURSES. Excellent opportunities for
odvancement in all areos of modern,
newly expanded I,OOo-bed Generol Hos-
pital, including O.R. ond Recovery, Inten-
sive Core, Emergency, Cenfrol Supply,
Medicol ond Surgicol Unifs.
Please contact:
Director of Nursing
HENDERSON GENERAL
HOSPITAL
Hamilton, Ontario
COLONEL BELCHER HOSPITAL
CALGARY, ALBERTA
EDUCATIONAL INSTRUCTOR
Up to $6,283 per annum
(depending on qualific"tions)
Duties: to conduct in-service troining for
Nurses and Ancillary Stoff. "
Qualifications: must be 0 Regisfered
Nurse preferobly with odvanced train-
ing in nursing educofion ond odminis-
frofion.
Apply immediately to the
Personnel Office,
COLONEL BELCHER HOSPITAL
Calgary, Alberta
Quote 998.
OPERATING ROOM NURSES
WE NEED
YOU
APPLY TO:
Director of Nursing Service
SUDBURY GENERAL HOSPITAL
Sudbury, Ontario.
76 THE CANADIAN NURSE
REGISTERED GENERAL
DUTY NURSES
For 75-bed ocfive hospifol located 70
miles Eost of Soskotoon.
Excellent personnel policies.
Apply:
Director of Nursing Service
ST. ELIZABETH'S HOSPITAL
Humboldt, Saskatchewan
SYDENHAM DISTRICT HOSPITAL
WALLACEBURG, ONTARIO
Exponsion, scheduled to open April I,
1967. Regi.t.r.d Nu.... - salary range
$400 . $480, per month commensurote
with experience ond quolificotions.
Regi.t.red Nu..ing A..istants - so lory
ronge $295 - $331 per month. Excellent
personnel polcies.
For further information and application
form please write:
Mrs. M. Brevik
Director of Nursing
SYDENHAM DISTRICT HOSPITAL
Wallaceburg, Ontario.
PORT COLBORNE
GENERAL HOSPITAL
PORT COLBORNE, ONTARIO
requires
A Supervisor for evening ond nighf rOfo,
tion of dUfy "and A Supervisor for in-
service educofion progromme for 166-bed
hospital within easy driving disfonce of
Americon ond Canadian mefropolilan
centres, considerotion given for previous
experience obtained in Conado. Comple.
tely furnished apartmenf-style residence,
including bolcony ond swimming pool
focing loke, odjocent fo hospitol.
Apply:
Director of Nursing
GENERAL HOSPITAL
Port Colborne, Ontario.
CAMPS HIAWATHA
IN THE LAURENTIANS
50 mile. from Montreal and EXPO
FOR GIRLS FOR BOYS
To compose its Medical Sfaff
for July ond August 1967
requires:
. A RESIDENT PHYSICIAN
. TWO (2) REGISTERED NURSES
. TWO (2) NURSES AIDES
Sfoff for the full summer is preferred, buf
orrangements for one monfh may be hod.
Excellent food ond living occommodofions;
Wonderful othlefic ond recreotional faci-
lifies.
Please call or write:
CAMPS HIAWATHA INC.,
1405 Bishop Street,
Montreal 25, Quebec
Tel.: 844-2556
NEW POSITION
IN.SERVICE CO.ORDINATOR
required
fO direcf, supervise ond porticipate in 0
progrom of In-Service Educofion. Require-
ments: Baccalaureafe degree. Experience
in nursing service and educafion. Keen
inferest in sfoff development. Initiofive
ond leodership ability.
Enquire:
Director of Nursing
ROYAL COLUMBIAN HOSPITAL
New Westminster, B.C.
ROYAL ALEXANDRA HOSPITAL
EDMONTON, ALBERTA
Modern ocfive treotment hospital Super-
visors required far doys, evening ond
night dUfy for Poediofric and Medical
Nursing Units. General DUly for 011 servi.
ces including Infensive Core Unit. Excel-
lent working conditions ond currenf per-
sonnel policies. Credit will be given for
previous experience ond Postgroduate
quolificofions.
Apply:
Personnel Office,
ROYAL ALEXANDRA HOSPITAL
Edmonton, Alberta
FEBRUARY 196
I. \It.j:.. 1\..( ,
REGISTERED & GRADUATE
NURSES
Are required to fill vacancies in a modern, centrally
located Hospital. Tours of duty are 7:30 - 4:00, 3:30 -
12:00 and 11 :30 - 8:00.
Salary range for Registered Nurses is $382.50 to
$447.50 per month and for Graduate Nurses is
$352.50 to $417.50 per month. We offer a full
range of employee benefits and excellent working
conditions.
Day Care facilities for pre-school children from 3
months to 5 years in age.
Apply in person, or by letter to :
Personnel Manager,
THE RIVERDALE HOSPITAL
St. Matthews Road,
Toronto 8, Ontario.
SCHOOL OF NURSING
BROCKVILLE
GENERAL HOSPITAL
Requires
TEACHERS
For the recently approved two year curriculum with
a third year of experience in nursing service. You
will enjoy participating in the development of a
progressive school which emphasizes planned learn-
ing experiences for the students. Theory is taught
concurrent with clinical experience.
Qualifications: Bachelor of Science in Nursing
or Diploma in Nursing Education
or Diploma in Public Health Nursing
Excellent salaries and personnel policies.
You would enjoy living in the attractive "City of
the Thousand Islands" two and one half hours from
Expo 67.
For further information contact:
The Director, School of Nursing
BROCKVILLE GENERAL HOSPITAL
Brockville, Ontario
BRUARY 1967
THE MONTREAL GENERAL HOSPITAL
offers a
6 month Advanced Course in
Operating Room Technique and
Management to
REGISTERED NURSES
with a year's Graduate experience
in an Operating Room.
Classes commence in September and
March for selected classes of
8 students
For further information apply to :
The Director of Nursing
THE MONTREAL GENERAL HOSPITAL
Montreal 25, Quebec
DIRECTOR OF SCHOOL
OF NURSING
REQUIRED FOR
DISTRICT SCHOOL OF NURSING
Minimum Requirement - B. Sc. N.. with five years
experience. two of these in Nursing Education.
Apply to:
Mr. Harold Swanson, Chairman,
BOARD OF NURSING EDUCATION
220 Clarke Street
WOODSTOCK, ONTARIO
THE CANADIAN NURSE 77
$700 monthly. Write: Personnel Director, Mercy Hos-
p ital, Bakersfield, California. 15-5-58A
REGISTERED NURSES: Excellent opportunity for ad-
vancement in atmosphere of med ico I excellence. Pro-
gressive patient core including Intensive Core and
Cardiac Core Units. Finely equipped growing 200-
bed suburban community hospital just on Chicago..
beautiful North Shore. Completely air conditioned
furnished apartments, paid vacation, ofter six months,
stoff development program, and liberal fringe bene-
fits. Starting salary from $466. Differential of $30
for nights or evenings. Contact: Donald L Thomp-
son. R. N., Director of Nursing, Highland Pork Hos-
pital, Highland Pork, Illinois 60035. 15-14-3 A
UNITED STATES
REGISTERED NURSES - Just over the Golden Gate
from Son Francisco in uMorvelous Morin". Modern ex-
panding 250 bed hospital. Opportunities in medical,
surgical obstetrical, ICU, OR, Cardiovascular, Psychia-
tric oreas. Dynamic inservice program. Salary. based
on education and experience starting from $600 to
$675. PM and night shift differentials of 10 % and
7 %. plus liberal employee benefits. Opportunities for
graduate study in nearby colleges and universities.
St;mulating, progressive hospital atmosphere plus ex-
citing off-duty attractions of nearby Son Francisco.
the Redwoods. ocean swimming and mountain skiing.
Contact: Personnel Director, Morin General Hospital.
Box 30 San Rafael, Cal ifornia. 15-5-69 A
Registered Nurses and Certified Nursing Alsistants.
Openinq in several areas, all shifts. Every other week-
end off, in small community hospital 2 miles from
Boston. Rooms available. Hospital paid life insurance
and other liberal fringe benefits. RN salary $100 per
week, plus differential of $20 for 3-11 p.m. and
11.7 a.m. shifts. C.N. Ass'ts. $76 weekly plus $10 for
3-11 p.m. and 11-7 a.m. shifts. Write: Miss Byrne,
Director of Nurses. Chelsea Memmorial Hospital,
Chelsea, Massachusetts 02150. 15-22.1 C
REGISTERED NURSES - CALIFORNIA Progressive hos-
pital in San Joaquin Volley has openings for R.N:s.
Located between Son Francisco end Los Angeles near
mountain. ocean and desert resorts. Paid vocation.
paid sick leave. paid Blue Cross. disability insurance,
voluntary retirement plan. Salary range from $500 to
Bli
SCHOOL FOR GRADUATE NURSES
McGill UNIVERSITY
PROGRAMS FOR GRADUATE NURSES
DEGREE OF BACHELOR OF NURSING
Two yeors from McGill Senior MOfriculofion or three years from McGill Junior
MOfriculotion or the equivolents. In First Yeor fhe student elects one clinical
setting in which to study nursing, selecting from
. Mafernol ond Child Health Nursing
. Medicol-Surgicol Nursing
. Mental Heolfh and Psychiotric Nursing
. Public Heolfh Nursing
In Final Yeor fhe sfudenf studies in nursing educolion, or nursing service
supervision, selecting from
· Teoching of Nursing
. Supervision of Nursing Service in Hospifals
. Supervision of Public Health Nursing Service
DEGREE OF MASTER OF SCIENCE (APPLIED)
A progrom of two ocodemic yeors for nurses wifh 0 boccoloureofe degree.
Students elect to mojor in:
. Development and Administrotion of Educotionol Progroms in Nursing
. Nursing Service Adminisfrofion in Hospitols ond Public Heolth Agencies
PROGRAM IN BASIC NURSING
leading to the degree Bachelor of Science in Nursing
A five.yeor progrom for students with McGill Junior Mafriculotion Or its equivalent.
This progrom combines ocodemic ond professional courses with supervised nursing
experience in fhe McGill teoching hospifols ond selected heolth ogencies. This brood
bockground of educafion, followed by graduofe professional experience, prepores
nurses for odvanced levels of service in hospifals ond communify.
for further particulars write to:
DIRECTOR, McGILL SCHOOL FOR GRADUATE NURSES
3506 UNIVERSITY STREET, MONTREAL 2, QUE.
78 THE CANADIAN NURSE
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DALHOUSIE
UNIVERSITY
Degr.. Course in Bosic Nursing - (B.N.)
4 years
A progrom extending Over four colendor
yeors leading to the Bachelor of Nursing
degree is offered to candidates wifh a
Nova Scofia Grade XII sfonding (or equiv-
alenf) and prepares the student for nursing
proctice in hospitals ond the community.
The curriculum includes sfudies in the
humonities, nursing and the sciences.
Degree Course for Registered Nurses -
(B.N.) - 3 years
A progrom extending over three ocademic
yeors is offered to Registered Nurses who
wish to obtain 0 Bachelor of Nursing
degree. The course includes studies in
the humonities, sciences ond 0 nursing
specialty.
Diploma Courses for Registered Nurses -
1 yea.
(1) Nursing Service Administration
(2) Public Health Nursing
(3) Teaching in Schools of Nursing
For further information apply to:
Directo., School of Nursing
DALHOUSIE UNIVERSITY
Halifax, N.S.
DALHOUSIE UNIVERSITY
offers
NEW DIPLOMA PROGRAM
in
OUTPOST NURSING
A program exfending over two colendar
yeors hos been developed to prepare
graduote nurses for service in remofe
areos of Northern Canada. Mojor oreas
wifhin the course of study will include:
Public heolth nursing
Complete midwifery
Bosic clinicol medicine
Insfruction will be highly individualized.
1st yeor - To be spent ot the Universify.
2nd yeor - To consist of on internship
directed by the Universify in
selected northern ogencies.
Condidofes should hove completed of
leost one yeor of professional nursing.
Upon completion of the progrom sfudents
will receive 0 Diploma in Public Heolth
Nursing ond 0 Diplomo in ÛlJfpost
Nursing.
For further information write to:
Director,
SCHOOL OF NURSING
DALHOUSIE UNIVERSITY
Halifax, Nova Scotia
FEBRUARY 191
UNITED STATES
iTAFF NURSES - Here is the opportunity to further
ievelop your professional skills and knowledge in
.ur I,OOO-bed medical center. We have liberal perso.nnel
>elicies with premiums for evening and night tours.
)ur nurses' residence, locoted in the midst of 33
ultural and educational institutions, offers low-cost
10using adjacent to the Hospitals. Write for our booklet
>n nursing opportunities. Feel free to tell UI whot type
)osition you are seeking. Write: Director of Nursing,
loom 600, University Hospitals of Cleveland, University
:ircle, Cleveland, Ohio 44-06 15-36-1 G
:egiltered Nur.. (Scenic Oregon vocation ploy-
,round, skiing, swimming, boating & cultural
.vents) for 295.bed teaching unit on campus of
Iniversity of Oregon medical school. Salary starts
.t $575. Pay differential for nights and evenings.
Liberal policy for advancement, vocations, sick
leave, holidays. Apply: Multnomah Hospital, Port.
land, Oregon. 97201. 1:1-38-1
Staff Nurs..: live with your family in on atTractive
2 bedroom furnished home for $55 per month,
including utilities, and work in a suburban Cleve-
land hospital. Starling salary range $420 - $445
with 6 and 12 month increments. Excellent transpor-
tation to hospital door. Outstanding schools and
cultural opportunities. Apply: Director of Nursing
Service, Sunny Acres Hospital, 4310 Richmond Road,
Cleveland, Ohio 44t22. 15-36-IE
GRADUATE NURSES - Wouldn't you like to work
at a modern 532.bed acute General Teaching Hos-
pital where you would have: (0) unlimited oppor-
tunities for professional growth and advancement,
(b) tuition paid for advanced study, (c) starting
salary of $429 per month (to those with pending
registration as well), d) progressive personnel poli-
ROYAL VICTORIA HOSPITAL
SCHOOL OF NURSING
MONTREAL, QUEBEC
POSTGRADUATE COURSES
1.
(a) . Six month clinical course in Obstetrical Nursing.
Classes - September and March.
(b)
Two month clinical course in Gynecological Nursing.
Classes following the six month course in Obstetrical
Nursing.
Eight week course in Care of the Premature Infant.
(c)
2. Six month course in Operating Room Technique.
Classes - September and March.
3.
Six month course in Theory and Practice in Psychiatric
Nursing.
Classes - September and March.
For information and details of the courses, apply to:
DIRECTOR OF NURSING
ROYAL VICTORIA HOSPITAL
Montreal, P.Q.
BRUARY 1%7
des, (e) a choice of areas? For further information,
write or call colle-ct: Miss Louise Harrison, Dire-ctor
of Nursing Service, Mount Sinai Hospitat University
Circle, Cleveland, Ohio 44106. Phone SWeetbriar
5-6000. 15-36.ID
STAFF NURSES: University of Washington. 320-bed
modern, expanding Teaching and Research Hospital
located on campus offers you an opportunity to
join the staff in one of the following specialties,
Clinical Research, Premature Center Open Heart
Surgery, Physical Medicine, Orthopedicts, Neurosur-
gery, Adult and Child Psychiatry in addition to
the General Services. Salary: $501 to $576. Unique
benefit program includes free University courses after
six months. For information on opportunities, write
to: Mrs. Ruth Fine. Director of Nursing Services,
University Hospital, 1959 N.E. Pacific Avenue,
Seattle, Washington 98105. 15-48-2D
UNIVERSITY OF
BRITISH COLUMBIA
School of Nursing
DEGREE COURSE IN BASIC
NURSING
DEGREE COURSE FOR
GRADUATE NURSES
Both of these courses lead to the
II.S.N. degree. Graduates are pre-
pared for public health as well as
hospital nursing positions.
DIPLOMA COURSES FOR
GRADUATE NURSES
I. Public Health Nursing.
2. Administration of Hospital
Nursing Units.
3. Psychiatric Nursing.
For information write to:
The Director
SCHOOL OF NURSING
UNIVERSITY OF B.C.
Vancouver 8, B.C.
OPERATING ROOM NURSE
FOR
DEEP RIVER HOSPITAL
Must hove successfully completed 0 post-
graduafe course in operating room tech-
niques or have had two or three yeors
experience. Fringe benefifs include super.
onnuation, holidays, group insurance, hOl-
pito! ond medical plans.
State all particulars in first letter to:
FILE 11 E
ATOMIC ENERGY 0 CANADA
LIMITED
Chalk River, Ontario.
THE CANADIAN NURSE 79
MY VERY OWN
STETHOSCOPE?
.
'-
- but of course!
ASSISTOSCOPE* was
designed with the
nurse in mind.
ASSISTOSCOPE* gives
you the acoustical
perfection of the
most expensive
stethoscopes.
ASSISTOSCOPE::: is available with black or
hospital-white tubing and ear pieces with the slim-fit
sonic head which slips easily under blood pressure cuffs
or clothing.
tCheck with your Director
of Nurlinl or P.A. today
on how you can buy
ASSISTOSCOPE at
speciallroup prices.
Order fromt
v../
N
U
I
M MONTREAL 21 QUE.EC
.TRADE MARK
VICTORIA GENERAL HOSPITAL
HALIFAX, NOVA SCOTIA
Invites applications from Registered Nurses
for all services including operating room,
recovery room, intensive care and emergency
in completely new wing.
Salary range for General Staff positions
$360.00 - $420.00 per month
and other liberal benefits.
Direct enquiries to:
Director of Nursing,
VICTORIA GENERAL HOSPITAL
3383
Halifax, Nova Scotia
80 THE CANADIAN NURSE
Index
to
advertisers
February 1967
Abbott Laboratories Ltd.
Ames Company of Canada Ltd.
Bland Uniforms Limited .
Boehringer Ingelheim Products ..
British Drug Houses (Canada) Ltd.
The Clinic Shoemakers ..
Canadian University Service Overseas
Depårtment of National Defense, Ottawa ...
Four Seasons Travel ..
Charles E. Frosst & Co.
W. J. Gage Co. Ltd. ......
Lakeside Laboratories (Canada) Ltd.
Lewis-Howe Company (Turns)
J. B. Lippincott Co. of Canada Ltd.
Mead Johnson of Canada Ltd.
C. V. Mosby Co.
J. T. Posey Company
Reeves Company ....
W. B. Saunders Company
Sterilon of Canada
Uniforms Registered
United Surgical Corporation
White Sister Uniforms Inc.
Winthrop Laboratories ....
Advertising
Manager
Ruth H. Baumel,
The Canadian Nurse
50 The Driveway,
Ottawa 4, Ontario
Advertising Representatives
Richard P. Wilson,
219 East Lancaster Avenue,
Ardmore, Penna. 19003
Vanco Publications,
170 The Donway West,
Suite 408, Don Mills, Ont.
Member of Canadian
Circulation Audit Board Inc.
14, 15
17
9
20
52
2
26
22
19
16
21
5
57
24
54
11
6
12
1
53
Cover III
55
Cover II
Cover IV
mE
FEBRUARY 1967
March 1967
U
IVE
SITY OF OTTAWA.
SChOOL OF NURSING
OT':'lÎi\A. aNT.
12-67-Q-L-I04-D
The
Canadian
Nurse
.
.:.\..
....
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..:
,
G .-
. v
'\
o'V
health care in the north
drug addiction
standardization of hospital
equipment
total care - for animals
Three outstanding professional fashions from WH ITE SISTER
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. . . in pediatric
nursing
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The revised and updated new edition of this widely-
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the mechanism of chemical reaction is explained and the
distribution of electrons in the shells and subshells of the
outer structures of atoms is discussed in detail.
By JOSEPH H. ROE, Ph.D. Publication date: March, 1967. 10th edition,
approx. 412 pages. 6 3 .4" x 9 3 .4", 55 illustrations, 3 in color. About
$7.50.
A New Book!
PEDIATRIC NURSING
Effectively integrating psychological aspects of child care
with a clear, comprehensive description of pediatric nurs-
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testing, common psychometric tests, nonnal nutrition and
mental retardation. Specialized areas of clinical pediatrics
and infonnation on growth and development are discussed
in great depth. The latest thinking is presented on: care
of the child with congenital heart disease; common inborn
errors of metabolism; prenatal influences on the baby in
utero.
By HELEN C. LATHAM, R.N., B.S., M.L., M.S.; and ROBERT V.
HECKEL, B.S.. M.S.. Ph.D. With the collaboration of ROBERT P.
THOMAS. M.D.. and MARGARET MOORE, B.S., R.N. Publication date:
May. 1967. Approx. 640 P a g es, 7" x 10" 139 illustrations About
$8.10. ,.
New 5th Edition!
A LABORATORY GUIDE IN CHEMISTRY
The new edition of this completely up-to-date manual pre-
sents 65 exercises on inorganic, organic and physiological
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tion and thin-layer chromotography. Though designed for
use with the new 10th edition of Roe, PRINCIPLES OF
CHEMISTRY, it easily adapts to use with any required text.
By JOSEPH H. ROE. Ph.D. Publication date: March, 1967. 5th edition,
approx. 240 pages, 5%" x 8%". 12 illustrations, 2 color plates.
figures A to L. About $4.05.
New 4th Edition!
CARE OF THE PATIENT IN SURGERY
Including Techniques
Presenting the newest concepts and approaches in care of
the patient in the operating room, the thoroughly revised,
superbly illustrated new edition of this popular text em-
phasizes fundamental principles in providing authoritative
guidance in all aspects of the nurse's duties in surgery. Two
entirely new chapters, "Surgery on the Ear" and "Ophthal-
mic Surgery," have been added. Basic requirements of an
operating room nursing service are definitively explained,
including a new approach to surgical suite design. The
most recent advances in chest, heart and gynecologic sur-
gery are discussed in detail
By EDYTHE LOUISE ALEXANDER, B.S., M.A., R.N.: WANDA BURLEY,
B.S., M.A., R.N.; DOROTHY ELLISON, B.S., M.A., R.N.; and ROSALIND
VALLERI, B.S., M.A., R.N. Publication date: March, 1967. 4th edition,
approx. 810 pages, 7" x 10", 555 illustrations, 5 in color. About $15.70.
THE C. V. MOSBY COMPANY, L TO.
86 Northline Road. Toronto 16, Ontario
lARCH 1967
Publishers
THE CANADIAN NURSE
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2 THE CANADIAN NURSE
MARCH 196;
The
Canadian
Nurse
A monthly journal for the nurses of Canada published
in English and French editions by the Canadian Nurses' Association
Volume 63, Number 3
26 Katherine E. MacLaggan - A Tribute
29 Medical Care of Eskimo Children
32 Nursing in the North
34 Outpost Nursing
36 Drug Dependency Research -
Expensive Luxury or Necessary Commodity?
39 Use of Narcotics in Addict Therapy
42 Care of Patients Addicted to Non-narcotic Drugs
45 Deserter of People?
47 Standardization
49 Hospital and Health Care - What Price?
March 1967
N. Steinmetz
Ruth E. May
Ingeborg Paulus
Robert Halliday
Mary L. Epp
Jean Wilkinson
George T. Maloney
S. J. Maubach
The views expressed in the various articles are the views of the authors and do not
necessarily represent the policies or views of the Canadian Nurses' Association
4 Letters 23 Dates
7 News 51 Research Abstracts
18 Names 53 Books
21 In a Capsule 58 Films
22 New Products 88 Official Directory
Cover photo courtesy l'Iiational Health and Welfare, Ottawa.
Executive Director: Heten K. Mussallem .
Editor: Vlrgtnla A. Llndabury . Assistant
Editor: Gtennls N. ZUm . Editorial Assistant:
Carla D. Penn . Circulation Manager: pter.
reUe HOUe . Ad\erlising Manager: Ruth H.
Bdumet . Subscrtptton Rates: Canada: One
Year. $4.50; two years, S8.00. Foreign: One
Year, $5.00; two years, S9.00. Single copies:
50 cents each. Make cheques or money orders
pa}able to The Canadian Nurse . Change of
Address: Fûur weeks'. notice and the old
address as well as the new are necessary. Not
responsible for journals lost in mail due to
errors in address.
Ci:) Canadian Nurses' Association. t966
o\RCH 1967
Manuscrtpt Informatton: "The Canadian
Nurse" welcomes unsolicited arlicles. All
manuscripts shoutd be typed. double-spaced.
on one side of unruled paper leaving wide
margins. Manuscripts are accepted for review
for exclusive publication. The editor reserves
the right to make the usual editoriat changes.
Photographs (glossy prints) and graphs and
gr;cl
O
:
w
iN
i
r
ict
s
'J!
Pe"Æ
:
is not committed to publish all articles sent,
nor to indicate deli",te dates of publication.
Authorized as Second-Class Mail by the Post
Office Deparlment. Ottawa, and for _ payment
of postage in cash. Postpaid at Montreal.
Return Postage Guaranteed. 50 The Driveway,
Ottawa 4. Ontario.
We mourn the death of our
President, Katherine E. MacLaggan.
The poignancy of our grief is
intensified by knowing that one of the
country's greatest leaders in nursing
has been taken from us prematurely.
Our consolation lies in the legacy
of inspiration and example that she
bequeathed to us.
Our greatest tribute to the late
president will be found not in words,
but in action - action that
continues her work and builds on
and elaborates her beliefs.
Dr. MacLaggan's objective was
to make the Canadian Nurses'
Association the strongest force for
nursing leadership in the country.
She was convinced that CNA haa to
speak out on issues affecting nurses
and nursing, and had to be the
body that generates action. She also
was convinced that the Association
had underestimated its own power
for exerting influence. "We are
80,000 members banded together,"
she often said, "and we have never
tapped our resources."
"Think big" was a frequent
admonishment from Dr. MacLaggan
when there was temptation to place
expediency first. She believed that if
Association objectives were to be
achieved, we could no longer "think
small" in terms of money, resources,
or other decisions that would affect
future generations of nurses.
Dr. MacLaggan always "thought
big." Those who continue her work
can do no less. - Editor.
THE CANADIAN NURSE 3
letters
{
Letters to the editor are welcome.
Only signed letters will be considered for publication
Name will be withheld at the writer's request.
Revised income tax act
Dear Editor:
I was delighted to read "Wanted - a
Revised Income Tax Act" (Editorial, Jan-
uary, 1967). Hoorah for you. We have
been quiet far too long.
Many of us mothers wonder whether it
is worthwhile to continue to put our skills
and knowledge to work. You have revived
the spark in us. Guide us in speaking "loud-
ly enough and in unison."
I would like to congratulate the staff
on the excellent issues that have been
published. - (Mrs.) J. Fedak, B.Sc.N..
Toronto, Ontario.
Dear Editor:
We have sent a copy of your editorial
(January, 1967) with a covering letter to
our local M.P. and a petition with 64 names.
Maybe our action will spur on other nursing
groups to do the same. - (Mrs.) O. Raws-
thorne, inservice education instructor, Vic-
toria General Hospital, Winnipeg, Man.
Not censored
Dear Editor:
An R.N. South Africa stated in "Letters"
(November 1966) that pages 17 and 18
had been removed from her June 1966
issue. She stated .....themail is censored
here and I would like to know what was on
the page that made them tear it off."
I checked the particular issue in the
library of the South African Nursing As-
sociation and find that page 17 carries an
advertisement by the Canadian Tampax
Corporation offering free color charts of
the standing female pelvic and reproductive
organs. Page 18 carried the excellent "New
Products'. section.
It seems that somebody was interested
in the products advertised, for it is a fal-
lacy that mail is censored in this country. -
Dr. Charlotte Searle, director, Division of
Professional Development, The South Afri-
can Nursing Association.
Extra copiesl
Dear Editor:
We are in need of copies of the January,
February, and March 1966 issues of THE
CANADIAN NURSE for our library and school
of nursing. If any readers have copies of
these issues available we would appreciate
receiving them. - R.N., Ontario.
A \lailable copies can be sent to The
Canadian Nurse, 50 The Dri\leway, Otta-
wa 4, Ontario. - Editor.
4 THE CANADIAN NURSE
University education
Dear Editor:
I wish to congratulate you and your co-
workers for the last issue of L'lnfirmière
Canadienne, which featured articles on uni-
versity nursing education.
We were very pleased with its presenta-
tion and I am personally very proud to see
it circulated throughout Canada and
abroad. - Sister Jacqueline Bouchard,
Director, School of Nursing, Université de
Moncton.
Dear Editor:
I read with great interest the December
issue, particularly the articles by Glenna
Rowsell and Margaret Steed. - Vera Osto-
povitch, nursing service advisor, Saskat-
chewan Registered Nurses' Association.
Dear Editor:
I enjoyed Glenna Rowsell's article in the
December issue. I want to congratulate
her on a fine job. - Myrtle Pearl Stiver,
former executive director of the Canadian
Nurses' Association.
Dear Editor:
I am very pleased to have an extra
copy of THE CANADIAN NURSE for Decem-
ber, which contains the feature on "Uni-
versity School of Nursing in Canada."
I think the article is very nicely done
and of service not only to prospective
students but to those of us in the schools
who meet so infrequently.
Please convey our appreciation to your
staff members with whom we had a pleasant
visit here in Montreal last summer.
Elizabeth Logan, Director, School for
Graduate Nurses, McGill University.
Dear Editor:
Thank you for the complimentary copy
of THE CANADIAN NURSE. I think the article
is very well done and you will be pleased
to know that as a result we have had ap-
plications to our school from other pro-
vinces. - Joyce Nevitt, Director, School
of Nursing, Memorial University of New-
foundland.
Dear Editor:
Thank you for your extra issue of THE
CANADIAN NURSE with the article on the
universities. It was a very kind gesture
and I do wish to compliment you on this
article. It will be most helpful, I am sure.
- Sr. Françoise Robert, s.g.c., director,
University of Ottawa School of Nursinll.
Ottawa.
From the four corners
Dear Editor:
I read with interest "Nurses on tho
Move," a letter to the editor by Mis
Rosemarie Gascoyne (October 1966)
Could we have permission to reprint it il
our Philippine Journal of Nursing? It wi!
be interesting reading for our nurses her
in the Philippines.
A suggestion that caught my attentio
is the possibility that the Internation
Nurses Association could "produce a syster
where a nurse would be acceptable an.
able to work in any country." I hope th
ICN will be able to evolve a commo
basic curriculum for approval of the bod
at the coming ICN conference in Canad.
I see a new look in The Canadia
Nurse. The cover page is pleasing to be
hold! Of all the magazines we have in Ol
library, your journal is the most referee, I
to by students and graduate nurses. - J05 I
E. Sumagaysay, executive secretary, Phi
lippine Nurses Association. I
Dear Editor:
Thank you for an excellent nursing ma
azine which has become the best in an
country. For years I have been passing m
copies on to students and graduates alikf
and they all comment that THE CAN ADlAI
NURSF has the best articles printed.
"Letters" (January, 1967) was most ir
teresting to me, an obstetrical supervisol
but I believe the finest article was in th
November, 1966 issue. I have read Mh
Pepper's article over and over again. I w
reading between the lines as I knew all c
the girls in the army pictures and spent som
time in Italy with No. 14 e.G. Hospiu
during the war. Keep up the good work. -
Marjorie (Lodge) Collister, Riverdale, I
linois.
Dear Editor:
I very much enjoy my monthly copy 0
THE CANADIAN NURSE. It is so informativ
and up-to-date! When one is away fror
home, in another country, news of one'
fellow nurses is wonderful for the morale
- Ruth A. Jort, Des Moines, Iowa.
Dear Editor:
I enclose a draft for my subscription t
THE CANADIAN NURSE for two further year.
In my opinion this is the best of th
nursing journals - all articles on a specifi
subject are contained in the same issu
rather than in several. This saves the bothe
of collecting them all together. - W.P
S.R.N., Cumberland, England.
MARCH 196'
llin spite of today's apparent explosion
in their awareness of sex,
young people are not well informed."
A recent study indicated that even
among college girls enrolled in health
education classes knowledge of menstru-
al facts was neither thorough nor accu-
rate. One reason, perhaps, for the lack
of accuracy was the fact that only 8% of
these girls obtained their information
about menstruation from doctors, nurses
or teachers.
Thi
small percentage probably
learned about menstruation because
they asked. Many young girls, however, never ask for
information-because they feel menstruation is not a
subject for discussion outside their homes. (And
sometimes very little information is available within
their homes.) Even the doctor is not likely to be con-
sulted unless the girl is concerned about a possible
abnormality.
One solution to this problem is to make information
on menstruation available to all young girls-whether
"
TAM PAX
SANITARY PROTECTION WORN INTERNALLY
MADE ONLY BY CANADIAN T.
MPAX CORPORATlON'LTD.,
BARRIE, ONT.
ARCH 1967
or not they specifically ask for it. Thus,
girls in health and physical education
classes, girls visiting school nurses, girls
at summer camp, girls consulting their
doctors-all should be provided with in-
formation on the normal changes that
are a part of growing up.
To assist you in explaining menstru-
ation to these girls we offer you (without
charge) laminated plastic charts drawn
by Dr. R. L. Dickinson, showing schemat-
ic illustrations of the organs of the female reproduc-
tive system. For the young girl we provide two free
booklets answering her questions about menstruation.
Send for them today. Professional samples of Tampax
menstrual tampons will also be included.
.
.
---
-
..'
1 Israel. S Leon: Obst. & Gynec. 26:920. 1965. 2 Larsen.
Virginia L. J. Am. M. Women's A. 20.557, 1965.
Canadian Tampax Cor,poration Limited,
P.O. Box 627, Barrie, Ont.
Please send free a set of Dickinson charts, copies of the two booklets,
a postcard for easy reordering and samples of Tampax tampons.
Name
Address
CN-I
THE CANADIAN NURSE 5
metronidazole
trichomonacide
oral tablets of 250 mg
vaginal tablets of 500 mg
Full information is available on request.
-Ru I e n c ""OH"
6 THE CANADIAN NURSE
MARCH 1967
news
Committee on Nursing Education
Begins Biennium
Canada's 188 nursing schools - diploma
and basic baccalaureate programs - gradu-
ated a total of 7,360 nurses in 1965. This
was an increase of on1y 99 over the previous
year. This small increase is not sufficient to
maintain present demands for nurses and
could result in an increasing shortage of
nurses with the coming of Medicare.
These figures were presented by Mrs. Lois
Graham-Cumming. Research Department.
Canadian Nurses' Association, to the Stand-
ing Committee on Nursing Education at its
first meeting of the 1966-68 biennium in
mid-February.
They represent on1y one of the problems
under consideration by the committee.
Chainnan Kathleen Arpin reminded the
committee, comprised of the elected repre-
sentatives on nursing education from the
10 provincial associations, that as a national
organization the CNA must undertake to
provide realistic policies and definitive state-
ments on nursing and nursing education.
The committee's job is to investigate thor-
oughly and recommend appropriate policies
to the Board for consideration and action.
The committee is expected to examine
certain specific areas of nursing education.
Recommendations regarding a definitive
statement on nursing, admission criteria in
schools of nursing, and the need for and
utilization of resources and facilities essential
for the practice and learning of nursing will
likely be made to the Board during the next
biennium.
Nation-wide Exams for
Canadian Nurses?
The first meeting of the Canadian Nurses'
Association's ad hoc committee on National
Examinations was held in Ottawa on January
23-25, 1967. The committee had been asked
to explore and assemble all data pertinent
to the development of a Canadian system
of registration examinations (machine-scor-
ed), and to make recommendations to the
CNA Board of Directors as to possible CNA
involvement.
The need for immediate action on Cana-
dian nursing examinations has arisen because
the American Nurses' Association recom-
mended at their meeting in June, 1966, that
the National League for Nursing discontinue
the use of examinations in jurisdictions out-
side the United States. The National League
for Nursing has notified those provinces
that are now using the examinations that
they will not be available as of 1969.
MARCH 1967
CNA Auxiliary Meet
.
1;::'\
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-
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,
, .
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\
Two members of the Canadian Nurses' Association National Office Auxiliary,
Miss E. Cale, President (right) and Mrs. G.p. Williams (left) examine a recent
issue of The Canadian Nurse with Editor Virginia Lindabury. The Auxiliary,
which was organized in 1955 to entertain international visitors and to help
with the cataloguing and indexing of periodicals in the CNA library, held
its annual meeting early in February at National Office.
At the three-day meeting, the committee
investigated measures for developing a Cana-
dian system of examinations, and considered
interim measures for the provinces until such
a service could be established.
Mrs. Mary Shields, fonnerly of the Test
Construction Unit of the National League
for Nursing, was guest speaker at the meet-
ing. She spoke on the procedures and prob-
lems in the development of licensure exam-
inations.
The committee has prepared recommenda-
tions for submission to the Board of Di-
rectors meeting in March.
Official Opening - CNA House
Her Excellency, Madame Georges P.
Vanier, wife of Canada's Governor-General,
will officially open the new home of the
Canadian Nurses' Association on Wednes-
day, March 15, 1967.
The opening of CNA House will precede
the meeting of the CNA Board of Directors
on March 16 and 17 so that full repre-
sentation of all association members will be
assured.
On this occasion the Board, on behalf of
all CNA members, will be host to state
officials and representatives of national asso-
ciations and agencies who will be invited to
attend the ceremonies.
The first sod for the $800,000 building
was turned on April I, 1965. The office
building provides 20,000 square feet of office
space. Architect J.W. Strutt designed the
building.
Nurses Speak at Hospital
Administrators' Meeting
Four nurses formed the faculty for a
day at the Second Educational Assembly
on Hospital Administration held by the
American College of Hospital Administra-
tors, District 8, in Winnipeg early in Jan-
uary.
Miss Margaret Steed, Consultant, Nurs-
ing Education for the Canadian Nurses'
Association; Miss Jean Anderson, Director
of Nursing Service at Victoria Public Hos-
pital, Fredericton; Sister Thérèse Caston-
guay, Superintendent of Nursing Educa-
ûon for Saskatchewan; and Mrs. K. Mc-
Laughlin, Research Analyst in Nursing at
the Victoria General Hospital, Winnipeg,
THE CANADIAN NURSE 7
news
examined the question "Who will give nurs-
ing care?" on the first day of the sessions.
"Nursing care should be given by a
nurse, qualified and registered for the prac-
tice of nursing. Until nursing care is ad-
ministered by nurses we cannot hope to
solve our nursing service problems quali-
tatively," Miss Steed told the audience.
She defined the CNA's recommendations
regarding the two categories of nurses, their
preparation and utilization as a means for
improving patient care. "The care func-
tions are the ones now most often dele-
gated to nursing assistants and nursing
aides." She noted that nursing service will
need to be complimented by auxiliary per-
sonnel, but told the hospital administra-
tors that a need for interpretation and cla-
rification of the roles, functions, and res-
ponsibilities of all those employed to per-
form nursing services was essential.
About 140 hospital administrators from
across Canada attended the five-day meet-
ing. The seminar sessions on "problem
areas," at which the nurses spoke, was
limited to 50 delegates to ensure effective
participation in the discussion.
Institutes on New Educational
Program in Saskatchewan
.'\ series of six workshops on nursing
education are being sponsored by the Saska-
tchewan Department of Education, Nursing
Education Division. The workshops are for
teaching personnel in nursing schools and
other persons interested in the proposed
changes in nursing education in the province.
Three workshops are scheduled for Regina
and three for Saskatoon. They were organiz-
ed to help prepare nurse educators for
changes that have revolutionized the pattern
of nursing education within the province
since the responsibility for nursing educa-
tion was transferred from the Department
of Public Health to the Department of
Education in April, 1966.
The changes include the est<lblishment of
two regional schools and the closure of all
existing hospital nursing programs. The first
of the two regional schools is expected to
open its doors to some 250 students this
fall in Saskatoon. Hospital schools in Prince
Albert, Humboldt, Yorkton, and Saskatoon
will no longer admit students. No date has
been set for the opening of the regional
school for the southern region of the pro-
vince, and hospitals there will continue to
operate existing programs.
Miss D. Rowles, supervisor of the nursing
program at Ryerson Poly technical Institute
in Toronto, was guest speaker at the fÌlst
institute on January 17 in Saskatoon. She
spoke on nursing programs within education-
al institutions. Dr. H.K. Mussallem, exe-
cutive director of the Canadian Nurses'
8 THE CANADIAN NURSE
Auxiliary Donates Bus Shelter
'\
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I
'I
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..
.
The Riverview Hospital Auxiliary in
Windsor recently made a unique and
practical contribution to patients and
their visitors. At a cost of $1,650 the
Auxiliary had a bus shelter built directly
across from the hospital.
According to Phyllis Purcell, public
relations chairman of the Riverview
Auxiliary, the need for a bus shelter to
pratect hospital visitors from the cold
winds that blow across the Detroit River
has been recognized for some time. Last
.0 ...
'.
.
..'
.... ..
" " '
I r
''f
d
I,
" .
--
---
year, the hospit<ll board asked the Auxil-
iary to assume the cost of this project.
The Auxiliary hoped to have a metal
shelter built, but the cost was prohibitive.
Realizing that the shelter did not have
to be glamorous to serve its purpose, the
Auxiliary settled for a wooden building.
The design was approved by the city and
the shelter erected.
Now, both visitors and st<lff at River-
view can await the bus in comfort
thanks to an enterprising Auxiliary.
Association, addressed the second meeting
on February 24 in Regina. She stressed the
need for nurses to welcome change in our
nursing education practices, and pointed out
that change was long overdue.
Other workshops will be held in Regina
on April 17-18, when Mrs. M. Levine of
Chicago will speak on the selection of learn-
ing experiences, and in May, when Dr. R.N.
Anderson will discuss the evaluation of stu-
dent performance. In Saskatoon, Miss H.
Keeler, director of the nursing program
at the University of Saskatchewan, will
speak March 22 on the reasons for shorten-
ing nursing programs. In June, a workshop
on teaching by principles will be directed
by Mrs. R. M. Coombs of Hamilton, On-
tario.
Sister Thérèse Castonguay, superintendent
for the nursing education division of the
department of education, anticipates that the
workshops will aid existing faculty to pre-
pare for the coming programs.
Brockville Nurses Certified
As Bargaining Unit
After alìnost a year's wait, the Nurses'
Association at Brockville General Hospital
has been certified as a bargaining unit by
the Ontario Labour Relations Board. The
collective bargaining phase now can begin.
The Nurses' Association proposed that the
bargaining unit consist of all registered and
graduate nurses, both full-time and part-
time, who are employed by the Brockville
General Hospital. The hospital proposed a
unit of "all graduate nursing staff regularly
employed in the nursing units, nursery,
emergency department, operating room, cen-
tral service and delivery room, save and
except assistant head nurses and persons
above that rank and daily basis relief nurses'"
The unit as finally certified by the On-
t<lrio Labour Relations Board includes all
registered and graduate nurses at B.G.H.
who are engaged in nursing care and in
teaching, except head nurses and persons
above the rank of head nurse, and those
regularly employed for not more than 24
hours a week.
The Labour Relations Board further stated
that aU registered and graduate nurses at
B.G.H. who are engaged in nursing care
and regularly employed for not more than
24 hours per week "constitute a unit of the
employees of the respondent appropriate for
collective bargaining."
The Brockville group is the third Nurses'
Association in Ontario to be certified as
a bargaining unit. Nurses at Riverview Hos-
pital, Windsor, and at St. Joseph's General
Hospital, Peterborough, were certified in
1966.
(Continued on page 10)
MARCH 1967
THE CLEAN WAY TO RINSE PATIENT UTENSILS
AMSCQ-GRAY diverter valve
Simple, clean, modern and effective. That describes AMSCO's popular
Gray Diverter Valve. This chromed hoseless bedpan-emesis basin rinser is
easily installed as part of the water closet. Both hands are free to hold
the bedpan. The water closet flushes normally with the added feature of
being equipped to spray-rinse patient utensils as soon as they become
soiled. This immediate rinsing of each patient's utensil in the
patient's room minimizes the possibility of cross contamination.
In existing or new construction, installation takes only minutes
and is accepted under the most rigid plumbing codes.
There is no cleaner and safer way to rinse patient utensils.
Write for brochure SC-367R
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a show of hands...
news
NEW FORMULA ALCOJEL, with
added lubricant and emollient, will
not dry out the patient's skin -
or yours!
r
(Continued from page 8)
P.E.I. Discusses Collective
Bargaining
A three-phase plan of action for better
salaries and working conditions for Prince
Edward Island's nurses was proposed by a
Conference on Socio-economic Welfare in
Charlottetown in mid-January.
Representatives from all but two of the
Island's hospitals met for a three-day session
on collective bargaining for professionnal
personnel. Miss Glenna Rowsell, nursing
consultant, Canadian Nurses' Association, I
chaired the conference, which was attended
by about 30 persons each day.
The provincial association is presently
unable to bargain under the Labour Rela-
tions Act in the province, and the nurses
wished to ascertain the prospects for im-
proving their economic position through
collective bargaining. PEl's nurses are among
the lowest paid in Canada.
The conference drew up a plan of action
for the coming year. The first step is to
inform the members about labor legislation
and to discover the kind of legislation want-
ed. The association may then suggest the
appropriate legislation and undertake to
convince the provincial legislature of the
practicability of the nurses' stand.
"This three-phase attack - involvement
of the members and promotion of educa-
tion on industrial relations legislation, fol-
lowed by an Association stand on the type
of legislation suited to the needs of its
nurses, followed by a concerted effort to'
convince the legislature - is a most in-
telligent and workable plan," reports Miss
Rowsell. "It could eventually lead to more
satisfied nurses - and better patient care."
....
1
nroves its sITloothness
ALCOJEL is the economical, modern,
jelly form of rubbing alcohol. When
applied to the skin, its slow flow
ensures that it will not run off, drip
or evaporate. You have ample time
to control and spread it.
ALCOJEL cools by evaporation. .
cleans, disinfects and firms the skin.
:.'
Your patients will enjoy the
invigorating effect of a body rub with
Alcojel .. the topical tonic.
Jellied
RUBBING
ALCOHOL
Gifts to Archives
The Mary Agnes Snively Archives Col-
lection at CNA House continues to grow.
Three neW gifts to the collection have
recently been received.
A collection of books, including a set of
Keating's Cyclopedia of the Diseases of
Children, 1890, was received from the
Miramichi Hospital, Newcastle, N.B. A
print depicting a hospital scene in Middle-
sex, England, in 1808 was donated by Lucy
R. Seymer, author of various histories of
nursing.
The most recent addition was a memo-
rial plate presented by the Medicine Hat
Chapter of the Alberta Association of Re-
gistered Nurses.
CNA Librarian Margaret Parkin ex-
pressed interest in further additions, espe-
cially to the collection of early nursing
caps. "We are anxious to receive the large
and unusual ones worn in the 1800's,"
she said. "We would like to receive any
distinctive Canadian ones for a special
Centennial year display."
ALCOJEL
r . coolin
efreshH,g... 9..
Send for a free sample
through your hospital pharmacist.
WITH
ADDED
LUBRICANT aøI
EPt10LUENT
BRITISH DIU8 HOUSES
'DII1II1TD r,A1IJIIo
ALCOJEL
THE BRITISH DRUG HOUSES (CANADA) LTD.
Barclay Ave.. Toronto 18. Ontario
10 THE CANADIAN NURSE
MARCH 1967
news
Quebec Nurses
Granted Certification
The United Nurses of Montreal, which has
organized within District No. 11 of the Asso-
ciation of Nurses of the Province of Que-
bec. reçently announced that the Quebec
labour Relations Board has granted certi-
fication to 10 groups of nurses in hospitals
and health agencies. It is expected that the
remaining 18 hospitals and agencies will
receive certification as soon as the petitions
are presented to the Labour Relations Board.
The union includes nurses in both mana-
gement and non-management positions.
All nurses in the district, both French
and English, are invited to become members
of the association. The United Nurses of
Montreal now has an office located at 3506
University Street. Room 14, Montreal.
DDS to Survey Nurses' Salaries
The Dominion Bureau of Statistics will
conduct a survey of salaries of graduate
nurses employed in the public general and
allied special hospitals of Canada.
The survey, to be carried out this spring,
is being undertaken with the active sup-
port of the Canadian NUises' Association
and the Canadian Hospital Association, and
with consultation from the Department of
Manpower and Immigration.
It is expected that survey results will
be available in the summer in a published
report by the Bureau. Salary data will be
presented according to the graduate nurses'
employment category (directors, supervi-
sors, head nurses, teachers, general duty),
their lay or religious status, and whether
they are currently registered or not. The
survey questionnaire will be designed so
that hospitals will be able to provide the
data from payroll or personnel records with
a minimum of effort.
The Canadian Nurses' Association, with
the support of the Canadian Hospital As-
sociation, requested the survey. Salaries
of many professional types are available
in Canada but nurses, of whom so many
are employed in hospitals, do not have any
valid salary information that can be com-
pared from region to region in Canada.
The Dominion Bureau of Statistics has
agreed, therefore, to approach hospitals in
Canada and obtain from them the salary
information from payroll data as of Feb-
ruary 28, 1967, for all full-time personnel
employed in the nursing categories out-
lined.
All graduate nurses who are employed
on a full-time basis are to be included in
this survey. If a nurse is employed in a
dual position, her entry in the position in
which she spends the major portion of her
time will be recorded.
MARCH 1967
Space Suits For Nurses
NUl"'ies worklOg in the operating rooms
of the new 300-bed Riverside Hospital of
Ottawa are becoming used to being teased
about their "space suits." It is true, how-
ever, that their two-piece trouser-suits with
the built-in boots do resemble costumes
from a science-fiction TV serial.
The use of the oc<:lusive garb is a part
of a two-year controlled federal-provincial
research program on control of infections
in operating rooms.
Previous studies, such as the one carried
out at the Barnes Hospital, St. Louis, have
shown that the perineum, thighs, and feet
are primary sources of viable bacteria and
that these organisms become airborne in
the course of normal activity. The neck,
arms, and waist openings are apparently not
important as sites for the escape of skin
organisms.
Conventional operating room dress per-
mits the escape of skin bacteria from the
lower extremities, so the staff at River-
side are using a trouser and blouse outfit.
The one-piece trouser-shoe outfit is made
of an all-cotton tightly-woven fabric; a tie
at the ankle provides for length adjustment.
The shoe has the conductive sole. The tunic
is three-quarter length with back fastenings
and is made of regular cotton. A special
over-boot is worn in the theatre as addi-
tional protection.
The trouser-suits are worn only in the
theatre section of the hospitat. No one
other than the operating room staff in their
specially designed outfits and the patients
ready for surgery are admitted to the
operating room areas.
Miss Olive Brissett, a graduate of Wan-
.stad Hospital, London, England, is shown
modeling the outfit for THE CANADIAN NURSE.
/
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"
Nurses Serve Abroad With
External Aid
A reputation for "quality, professionalism
and flexibility" has been earned by Cana-
dian nurses, who represent 60 percent of
those serving abroad under Canada's Ex-
ternal Aid Program.
Whether as a staff nurse in Vietnam, a
pediatric nurse in Tunisia, or a nursing
instructor in Trinidad, the Canadian nurse
is playing an important part in the External
Aid program.
As part of its program the External Aid
Office fills requests from various under-
developed countries for medical personnel.
A file in the International Health Divi-
sion of the Department of National Health
and Welfare contains the personal history
forms of nurses interested in serving abroad.
From this file and through consultations
with the Canadian Nurses' Association and
the university schools of nursing, Dr. B.D.B.
Layton, principal medical officer, is able
to fill the requests for medical person-
nel.
Salaries are arranged to be as attractive
as possible. Above a basic salary, which
is commensurate with World Health Organ-
ization and Pan American Health Program
salaries, Canada's External Aid Program
provides a non-taxable overseas allowance.
To keep the program from defeating its
purpose. a five-year maximum time limit
has been set on overseas service. "In theory
a country is setting out its own health
plan," said Dr. Layton. "We provide tem-
porary help for the country, not careers
for ourselves."
In most cases, the Canadian nurses help
to staff existing hospitals or schools of
nursing. In Tunisia, the Canadian Govern-
ment has undertaken a different type of
THE CANADIAN NURSE 11
Public Support Needed For
Psychiatric Programs
Voluntary organizations in mental hea1th
services are neglected, according to C.A.
Roberts. executive director of the Clarke
Institute of Psychiatry in Toronto.
Dr. Roberts, who presented the first an-
nual C.M. Hincks Memorial Lectures at the
University of Ottawa's Faculty of Medicine
in February, appealed for more public sup-
port in mental health programs. "Where
there is public apathy," he said, "poor health
ervices result."
Dr. Roberts pointed out that voluntary
organizations can be very effective in chang-
news
project in agreement with the Tunisian
government. The Hôpital d'Enfants in Tunis
is being operated by a staff of 49 Canadians
who fill positions as medical advisors,
pediatric nurses, radiologists. and physio-
therapists
The challenges and opportunities that
the External Aid Program offers are varied.
Canadian nurses have become international-
ly known through their readiness to part-
icipate in all aspects of the program.
/
I
!
I
\
\
.\
.'
,
I
2
.Prlces quoted are Suggested Retail Prices
For name of your ne.,e.1 d..ler. write:
NATURALIZER DIVISION, BROWN SHOE
COMPANY OF CANADA. LTD.. PERTH, ONTARIO
12 THE CANADIAN NURSE
ing public attitudes toward mental illness
and in removing the stigma that still sur-
rounds this type of illness.
The Hincks Memorial Lectures, a tribute
to Dr. Clarence M. Hincks, founder and
first director of the Canadian Mental Health
Association, will be presented annually in '
an Ontario university having a medical
school.
Invitations Available For
Expo Attraction
A series of 28 lectures to be presented
by internationally known experts in their
fields will be a feature attraction at Expo
67 this year.
Of special interest to nurses will be lec-
tures by Sir Macfarlane Burnet, Nobel
Laureate (Medicine) from Australia, (June
12th); Dr. William Barry Wood Jr., Direc-
tor of The Johns Hopkins University Depart-
ment of Microbiology, (June 19th); and Mr.
K. Helveg Petersen, Authority of Adult Edu-
cation from Denmark, (June 26th). Other
topics will range from "Development Trends
in Contemporary Literature" to "Orient
Pearls in the World Oyster."
The lectures, sponsored by Noranda Mines
Linùted, will be delivered at the DuPont
of Canada Auditorium located On the site
of the Exhibition - lle Sainte-Helene.
The modern auditorium is completely
equipped for the simultaneous translation
of lectures into either English or French.
The lecture by Academician Mikhail ShOo
lokhov, to be delivered in Russian, will be
simultaneously translated into both English
and French.
Attendance at any of the one-hour lec-
tures is by special invitation only. Appli-
cations for invitations, or requests for in-
formation, should be sent to Mr. D. Hunka,
Organizing Secretary, Science Programme,
Expo 67, Mackay Pier, Montreal, P.Q. Ap-
plications, to be treated on a first-come-
first-serve basis, can be accepted only in
writing.
Canadian Doctors Visit China
At the invitation of the Chinese Medical
Association three Canadian doctors visited
the People's Republic of China for a five-
day observation tour of Canton and Peking
health facilities.
Dr. R. K. C. Thompson, President of
the Canadian Medical Association; Dr.
Walter MacKenzie, Dean, Faculty of Me-
dicine, University of Alberta; and Dr. A.
F. W. Peart, General Secretary, Canadian
Medical Association, visited in mid-Novem-
ber to observe medica1 education, medical
research and medical practice in China.
The Chinese Medical Association had
arranged for the visas for the delegation,
and planned a tour that included visits to
the Bethune Orthopedic Hospital (named
after Dr. Norman Bethune, a Canadian
physician who took part in the revolu-
tionary war and is considered a Chinese
hero), various institutes of the Academy
MARCH 1967
news
)f Medical Science of China, the Peking
\1edical College, the Red Star People's
:ommune, and the Canton Medical School.
Dr. Peart reported that the Canadian
Jelegation was impressed with the friend-
,iness of the Chinese doctors and their
Issociates, and their desire to have further
;ontact with Canadian doctors. "Informa-
:ion was given freely," Dr. Peart said.
'and we were not curtailed in taking pic-
lUres. Although we deliberately avoided
:liscussions about their revolution and the
::ommunist philosophy, which is comple-
tely contrary to our way of life in Ca-
nada, we all felt that further exchanges
between the doctors of our two countries
would be usefuL"
.::;rant Approved for Ontario
tHospital
A federal grant of $115,053 for the
I.O.D.E. Memorial Hospital in Windsor
has been announced by National Health
and Welfare Minister Allan J. MacEachen.
The grant will assist the construction of
an addition to the present hospital build-
ing. The addition, to be known as the
Osmond Wing, will consist of two single
story units. The two units will provide 52
beds for the care of psychiatric patients,
as well as space for community mental
health services and teaching areas.
Completion of construction is expected
this month.
'WHO, UNICEF Try
'New X-ray Units
New. simplified x-ray units specially
designed for use in rural health centers in
less developed countries or as stand-by
equipment in large hospitals are being test-
ed by the World Health Organization.
Cooperating in this venture are the United
Nations Children's Fund (UNICEF) and
leading manufacturers of x-ray equipment.
Prototypes of different possible machines
have been supplied by UNICEF to WHO
for field trials in the Republic of the Congo
(Brazzaville), Kenya. and Lesotho.
X-ray machines are important tools in
mass campaigns against tuberculosis and in
other diagnostic work. However, the ma-
chines now being manufactured are primarily
designed for use in hospitals and health
centers of technically-developed countries
and have been found too complicated for
operation in rural areas of developing coun-
tries. Because of the lack of trained per-
sonnel to operate the machines or the meager
or non-existent service facilities, units in
many hospitals are out of order most of
the time.
Under the technical guidance of medical
radiographers and physicists, WHO drew up
specifications for a simple, multipurpose ma-
MARCH 1967
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Nurses attending the Conference on Pediatric Nursing at the Hospital for Sick
Children toured the ward areas to see current equipment and procedures.
chine for use in these rural health centers
and urban areas of developing countries. Ir
the design, precautions have been taken
against the possibility of radiation damage
to the population. WHO anticipates requests
from governments for the training of x-ray
technicians and operators as a result of this
trial.
This investigation is of great value to all
countries where the servicing and repair of
x-ray apparatus present a problem.
Outbreaks of Measles and
Scarlet Fever in Quebec
Measles and scarlet fever are currently
approaching epidemic proportions in some
regions of Quebec. The director of health
for Quebec city, Dr. Jacques Roussel, has
declared that the number of cases in his
region is the highest in 10 years. The
provincial minister of health is giving
special attention to case-finding and treat-
ment of these two diseases.
Dr. A.R. Foley, director of the Epide-
miology Service of the Department of
Health, has pointed out that scarlet fever
usually strikes children from 5 to 15 years
of age. Even in a mild form the disease can
cause permanent disability if not treated.
At the early signs of scarlet fever, such
as sore throat and pyrexia, it is advisable
to consult a physician. Antibiotic and pro-
phylactic treatment is recommended for
those children who have had contact with
the disease.
Measles is characterized by cold symp-
toms followed by a rash. In children under
three years, the disease is often complicated
by bronchopneumonia.
Some doctors recommend administration
of anti-measles vaccine, but mass vaccina-
tion programs do not appear to be the ideal
solution at the present time.
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Pediatric Nursing Conference
To inform, to up-date, to assist through
talks, discussions and demonstrations -
these were the objectives of the three-day
Conference on Pediatric Nursing held early
in December at the Graduate Nurses' Resi-
dence of the Hospital for Sick Children,
Toronto.
Sponsored by the Hospital for Sick
Children Department of Nursing, the con-
ference demonstrated techniques and prac-
tices currently being developed and used
to ensure comfort and safety in the care of
young patients. Sixty-two nurses from
throughout Ontario attended the continuing
education session.
Displays were set up by each of the
six participating areas: recreation and
volunteers; emergency; intensive care; new-
born and premature; medicine - isola-
tion, and the committee for control of
infection; and surgery - including physio-
therapy, occupational therapy and dietary
departments.
The conference was designed to improve
the nurses' competence in such areas as
the hospitalized child and his family; im-
portance of play for the hospitalized child;
emergency nursing care of newborns and
prematures; nursing care in a pediatric
emergency department; factors to consider
in creating a safe environment for chil-
dren; nursing in the intensive care unit;
and meeting the needs of the long-term
patient.
Grants for Multiple Sclerosis
Research grants totalling $81,994. were
announced early in January by the Multi.
pIe Sclerosis Society of Canada.
Headed by Dr. John M. Silversides of
Toronto, the Society's Medical Advisory
Board meets annually to consider applica-
THE CANADIAN NURSE 13
news
tions from scientists at Canadian univer-
sities and hospitals. After careful scrutiny,
grants are awarded to those projects con-
sidered most appropriate. The research pro-
gram is coordinated with other areas of
neurological research in Canada, the United
States and Great Britain.
Five Quebec grants, four of them to
McGill University and the other to the
University of Montreal, totaled $39,500.00.
YES!
you can get pediatric
urine specimens easily,
every time
with Hollister's new
U-BAG
Those hard-to-get urine specimens from
infants and very young children are not
hard to get with the Hollister U-Bag. The
U-Bag makes it easy and certain, elimi-
nates backlog of specimen orders, gets
fresh urine in sufficient volume for any lah-
oratory procedure. The U-Bag fits girls as
well as boys and is won' with comfort and
security, with or without a diaper. Check
the list of benefi ts, then let us send you
some U-Bags for your own evaluation.
Write, using hospital or professional
letterhead, for free samples and ordering
informa tion.
The Holll.8ter V-Bas
fit. R.rls and boys
with equal eaie.
f j-IolLIsTER::
Il
HOLLISTER LTD., 160 BAY ST., TORONTO 1, ONT.
14 THE CANADIAN NURSE
Four othel grants were announced to the
Hospital for Sick Children, Toronto, the
University of Western Ontario, the Uni-
versity of Saskatchewan, and the Univelsity
of Toronto
To science, multiple sclerosis remains
the greatest unsolved neurological problem
of our time. There is no cure, not even
a definite knowledge of its causes. How-
ever, the disease has struck an estimated
30,000 Canadians, mostly in the 18-45 year
age group. Among the symptoms of MS
are blurred or double vision, tremors, loss
of coordination, staggering or stumbling
gait, speech difficulties, numbness. extreme
"1 ...
.n
&
H
E
.
T
,
Fits boys and girls with equal ease
Quick and simple to apply
Double-chamber design isolates
specimen from child's sensitive skin
"No-flowback" valves prevent urine
from backmg up when bag is tipped
No spilling. . . so body casts anll low
surgical wounds remain dry
Specimen IS protected from fecal
contamination
Urine stays in the bag. . . can
be sent directly to lab without first
being drained mto receptacle
Surgical adhesive holds bag in place
without tape
Bag rests comfortably between child's
thighs. . . gives complete freedom
of movement
Large capacity enables total-volume
collection
Available either sterile or non.sterile
Completely disposable after use
weakness and fatigue, and partial or com-
plete paralysis.
The Multiple Sclerosis Society of Canada
was founded 18 years ago and by the end
of 1967 will have allocated $763, I 82.88
for research and fellowship grants in an
effort to determine the cause and possible
treatment for this baffling neurological dis-
order. Additionally, through its 35 regional
Chapters staffed by volunteers, the Society
provides a Patients Services Program 10
patients and their families. Quebec Chap-
ters of the Society are active and the MS
Society forms a part of the Combined
Health Appeal of Greater Montreal. Head
Office of the Society was recently trans-
fered from Montreal to Toronto.
New Vaccination Regulations
A new International Certificate of Vac-
cination booklet has been in use since
January I, 1967 for all vaccinations per-
formed for international travel. The re-
vised form includes changes in the small-
pox and yellow fever certificates as amended
by the Eighteenth World Health Assembly
in May, 1965.
The International Certificate of Vacci-
nation or Revaccination against Smallpox
requires the physician to indicate that a
vaccine that meets the World Health Or-
ganization's requirements was used. The
origin and batch number of the vaccine
must be recorded.
The International Certificate of Vaccina-
tion or Revaccination against Yellow Fever
was amended 10 extend the validity of the
certificate from 6 years to 10 years. Cer-
tificates already in use are automatically
extended to be valid for 10 years.
Hospital Infection Kit Part II
Now Available
Part II of an information kit on con-
trol of hospital infections has been released
by the Ontario Hospital Association.
The material up-dates the work of the
Canadian Council on Hospital Accredita-
tion, includes a comprehensive section on
dietary department involvement, and in-
cludes new information on infection control
in laundry departments. A copy of an in-
fection reporting form currently in use in
a member hospital is attached.
Part I of the material on infections con-
trol was prepared in July 1966 in response
to needs revealed in the book The Control
of Infections in Hospitals, by W. H. Le
Riche, C. E. Balcom, and G. van Belle.
The book reported on a survey of hospitals
in Ontario and revealed problems in the
areas of infection control.
Since that time the Ontario Hospital As-
sociation has undertaken educational ser-
vices, including the publication of these
kits, to acquaint members with the details
of how an infection control program can
be instituted.
MARCH 1967
news
Cobalt Medications Withdrawn
From Market
The U.S. Federal Food and Drug Ad-
ministration in Washington announced in
mid-January the removal from the market
of medications with a cobalt base. These
medications were used in the treatment of
certain types of anemia. Manufacturers
have complied with this decision pending
the results of further studies on the ef-
fectiveness of the products.
In Canada, the same medications were
withdrawn from the market on December
27th following deaths due to cardiac failure
in drinkers of beer that had been made
with cobalt salts.
Quebec Interns and Residents
Get Better Salaries
The interns and residents of Quebec hos-
pitals, who had resorted to "study days" on
January 31 and February 7 to back demands
for better salaries, have accepted salary in-
creases offered by the provincial govern-
ment.
Interns who were receiving $3,060 per
year will get $3,770; final-year residents
who received $5,160, will get $6,170 under
the new agreement.
The residents and interns, who had re-
fused several previous offers from the
government, accepted the final offer on the
condition that increases will be brought in
line with those of their Ontario colleagues
if the report of the Castonguay Commission
has not been submitted by July I, 1967.
A commission under M. Claude Caston-
guay has been set up to inquire into health
and social welfare in the province. The in-
terns' group is preparing a brief for the
Commission that will outline the grievances
of the interns and residents, and which is
intended to serve as a basis for future
negotiations.
u.S. Dermatologist Speaks Out
Neither parents nor teenagers, but priv-
ate physicians, are "contributing most" to
the increasing venereal disease problem in
the United States.
So says Arthur C. Curtis, M.D., Chair-
man of The University of Michigan's
department of dermatology.
In an editorial in the current University
of Michigan Medical Center Journal, Dr.
Curtis says incidences of infectious syphilis
and gonorrhea are continuing to increase,
although fewer private physicians are re-
porting cases to health departments. He
further asserts that those suffering most are
the nation's young people.
MARCH 1967
"Our children are our most important
asset," points out Dr. Curtis. "We should
do all we can to make them knowledgeable
about those things that may harm them,
and do all we can to make this information
possible for them to obtain."
year and hence infect more and more
young people."
Dr. Curtis believes physicians should
explain the serious nature of the problem
with the patient, enlisting the patient's
support in reporting the case.
"Physicians who treat V.D. can be good
epidemiologists but they don't have the
time or the experience to seek out contacts."
Every city, state or county health
department has trained workers who are
expert in finding infectious venereal disease
and bringing it to treatment, Dr. Curtis
explains. "Why don't we use them?"
Recommending more V.D. instruction in
schools, Dr. Curtis says that by treating
and not reporting, "we physicians in priv-
ate practice are the ones who are contribut-
ing most to this infectious venereal disease
problem among our young people. By
treating and not reporting, we are allow-
ing an infectious disease to increase each
ONE-STEP PREP
with
\ FLEET ENEMÞ:
single dose
disposable IlII it
FLEET ENEMA's fast prep time obsoletes soap and
water procedures. The enema does not require warm-
ing. It can be used at room temperature. It avoids the
ordeal of injecting large quantities of fluid into the
bowel, and the possibility of water intoxication.
The patient should preferably be lying on the left side
with the knees flexed, or in the knee-chest position.
Once the protective cap has been removed, and the
prelubricated anatomically correct rectal tube gently
inserted, simple manual pressure on the container
does the rest! Care should be taken to ensure that
the contents of the bowel are completely expelled. Left
"""t
colon catharsis is normally achieved in two to five
minutes, with little or no mucosal irritation, pain or
spasm. If a patient is dehydrated or debilitated,
hypertonic solutions such as FLEET ENEMA, must
be administered with caution. Repeated use at short
intervals is to be avoided. Do not administer to children
under six months of age unless directed by a physician.
And afterwards, no scrubbing, no sterilisation, no
preparation for re-use. The complete FLEET ENEMA
unit is simply discarded!
Every special plastic "squeeze-bottle" contains 41f2
fl. oz. of precisely formulated solution, so that the
adult dose of 4 fl. oz. can be easily expelled. A patented
diaphragm prevents leakage and reverse flow, as well
as ensuring a comfortable rate of administration.
Each 100 cc. of FLEET ENEMA confains:
Sodium biphosphate . 16 gm.
Sodium phosphate. 6 gm.
!-or our brochure: "The Enemo: Indications and Techniques",
containing full information, write to: Professional Service
Department, Charles E. Frosst & Co., P.O. Box 247,
Montreal 3, P.Q.
...-- ..-
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A QUALITY PHARMACEUTICALS
J..ow
E;.
&Co.
IIO"'RE:AL CANADA
'--- FDUNDlD IN CANADA IN 18f19
THE CANADIAN NURSE 15
news
AMA Supports
Nursing Salary Raise
A "significant improvement in the in-
come of the registered nurse" was called
for by delegates to the American Medical
Association's recent biannual session.
The House agreed with the Board of
Trustees and AMA's Committee on Nur-
sing which supports the need for a signi-
ficant improvement in the income of the
registered nurse. They recognize that there
will be considerable variation in compen-
sation depending upon the prevailing local
conditions, training, experience, and degree
of delegated responsibility.
The House also voted to continue to
support in principle all current nationally
approved educational programs for nurses.
It noted that the American Nurses' As-
sociation and the National League for
Nursing have called for nursing education
to take place in colleges and universities.
Support for the nurses' salary raise was
also voiced in an editorial in the Decem-
ber 12 issue of The AMA News, a weekly
newspaper published by the American
Medical Association. The editorial said:
Facts about
Registered
Nurses in
Canada
"Overworked and underpaid nurses have
been given support for better wages and
working conditions by the House of Deleg-
ates of the AMA.
"The House noted that the American
Nurses' Association in June adopted a
national salary goal of $6,500 for registered
nurses beginning practice. But the House
agreed with the report of the Board of
Trustees and the Committee on Nursing
which questioned such a national salary
goal, establishing a minimum rate of com-
pensation for the entire country.
"A salary for registered nurses should
be controlled by economics and the supply
or demand in the part of the country
where the nurse is employed. There is
considerable variation in compensation
depending upon the prevailing local condi-
tions, training, experience, and the degree
of delegated responsibility.
"The ANA's goal was adopted in the
belief that low salaries seriously hamper
efforts to recruit nurses and to keep nurses
in practice. In an interview printed in the
November 28 issue of The AMA News,
Jo Eleanor Elliott, RN, president of ANA,
said many nurses with current licenses are
not working because it is not economically
feasible.
"'As long as these inactive nurses keep
their licenses current, there is a potential
to alleviate the nurse shortage,' she said.
Turnover Rate
'The ANA is making a major effort to at-
tract these inactive RNs back into nursing.
But they must be given the proper motiva-
tion - including better wages and working
conditions - to make it worth their while."
Tooth Transplantation
Possible
A tooth that has grown in a wrong posi-
tion can now be extracted and transplanted
according to a new method practiced by
Swedish dentist Dr. Karl-Erik Thonner at
the Stockholm County Clinic of Ortho-
dontics, Näsby Park, Sweden. While keep-
ing the tooth alive in the patient's own
blood serum during surgery, Dr. Thonner
has operated on some 30 patients with good
results.
"It was surprising even to us when we
found out that this was possible," Dr. Thon-
ner says in a Stockholm newspaper inter-
view. "When we started, we used to give
the tooth a root filling after it had been
transplanted. Then we discovered that it was
rossible to keep the nerve functions alive in
the patient's own blood serum during sur-
gery. ..
Usually only 15 minutes are required to
prepare the insertion of the tooth. It has,
however, been possible to keep the tooth
alive up to at least one hour, the doctor
reports. The operation proper takes about
an hour to perfonn.
Graph shows turnover rate of full-time general duty nurses in public general
hospitals in Canada, 1964. The turnover rate is a ratio of leavers to stayers.
In 1964, the turnover rate for full-time general duty nurses in public general
hospitals in Canada was 61 percent. This means that the number of resignations
during the year was more than one-half of the average number employed
during the year.
Percent
100
.
,
.
. ,
. I . I . . I
Ø() .. -...... ... ..t.-.-...-..-- --f-- ---------t---------- f----------f---------.;-------- -t -. ---.. ----
. . I . . I
I . I , . .
. . I .. .
I I I I. .
6() ----....-...+---------f---.--.............--..-------
.._.. .... ---------i---------t.....----
= , ; ! :
, , ,
I I I I I .
40 ---- - - - - - t - - - - - - -"t-----------t----------t----------t---------t---------t- u -------
I I . . . I .
I . . . . I .
. . I . I . .
. I . . . . I
I . I I . . .
20 . - - - - - - --"'!'" - - -- - - - -
-----------!----------'!-.--------'!"---------'!---------'!-..-------
. . I . . . .
: : : : : : !
. . . . . I .
Source: Research Unit,
Canadian Nurses
Association, 1966
16 THE CANADIAN NURSE
1-
9
10-
24
25-
49
50-
99
SIZE OF HOSPITAL (Number of beds)
100-
199
200-
299
]()() -
499
500- 1000+
999
MARCH 1967
One day of walking down
those long corridors...
and standing on those
cold, hard floors will tell
you the importance of
White Uniform Oxfords
by Savage.
Savage White Uniform Oxford shoes
are made to take the strain off feet that
walk and stand on hard floors day in.
day out. They are expertly fashioned
over well-designed lasts to give true
comfort. Sanitized too for lasting fresh-
ness. And wearing White Uniform
Oxfords by Savage doesn't mean you
I
..
have to give up style for comfort. You
get a choice of military or flat heels in
a full range of sizes and widths. Sure
you'll still be on your feet for hours every
day. And the corridors won't be any
shorter. But you'll find it much easier
to carryon smiling in White Uniform
Oxfords by Savage.
WHITE U
ORMS
by Sayage
,
,
, .
.
..' . . . .
..... .
\
Style No.
Style No. 57825 ,_
57815
Style No. 1684&
BB 1239
names
Margaret Ellen Cam-
eron, a native of
Winnipeg, Manitoba,
recently assumed her
new duties as execu-
tive director of the
Manitoba Association
of Registered Nurses.
A graduate of the
School of Nursing of
the Winnipeg General Hospital, Miss Cam-
eron also holds both her baccalaureate
and master of science degrees from Teachers
College, Columbia University, New York.
The new executive director has been
active both in her profession and in various
nursing organizations since the beginning
of her career. She has held various posi-
tions in the United States including that of
school nurse in Connecticut, instructor at
St. Luke's Hospital, New York and as-
sistant director of the St. Luke's Hospital
School of Nursing.
Following her experience in the United
States, Miss Cameron returned to her home
town to become assistant director of nurs-
ing at the Winnipeg General Hospital.
The following year she became director of
nursing, a position she held until 1963.
Prior to her present appointment, she serv-
ed three years as assistant administrator
of the same hospital.
Her membership in nursing organiza-
tions, both provincial and national, included
the chairmanship of the education com-
mittee of the Manitoba Association of
Registered Nurses.
As executive director, Miss Cameron is
"pleased to participate in an expanded
program for the Manitoba Association of
Registered Nurses," and looks forward "to
working with my colleagues in its develop-
ment."
....-
-
-
II
Marie Fountain, born and educated in
England, has been appointed administrative
assistant (nursing) to Jean Milligan at the
Ottawa Civic Hospital.
Miss Fountain graduated from Central
Middlesex Hospital School of Nursing and
emigrated to Canada in 1957. Before mOv-
ing to Ottawa in 1959 she worked at hos-
pitals in Weiland, Ontario and Banff, Al-
berta.
At the Ottawa Civic, Miss Fountain
worked as a head nurse and administrative
supervisor before obtaining a diploma in
nursing administration and education from
the University of Ottawa in 1963. She is
presently completing her requirements for
her B.Sc. degree at the University.
18 THE CANADIAN NURSE
Pearl G. Morcombe
is the new public
relations officer for
the Manitoba Associa-
tion of Registered
Nurses.
Mrs. Morcombe
graduated from the
General H 0 s pit a I
School of Nursing,
Port Arthur, Ontario and is presently fol-
lowing an extension course in executive
administration at the University of Mani-
toba.
Mrs. Morcombe brings an impressive
background in both nursing and public rela-
tions to her new job. She spent three years
in industrial nursing at MacDonald Air-
craft in Winnipeg. From 1955 to 1958 she
acted as. public relations and field services
representative with the Manitoba Hospital
Services Association in Winnipeg. From
1958 to 1962 she was liaison officer for
the Manitoba Hospital Commission.
Prior to her new appointment Mrs. Mor-
combe spent five years as assistant to the
manager of hospital construction for the
Manitoba Hospital Commission.
...
....
...
.-Å.
Wilhelmina Bell is
the new director of
nursing service at the
General and Mar-
ine Hospital, Owen
Sound. A graduate of
the Royal Victoria
Hospital School of
Nursing in Montreal,
Miss Bell subsequent-
ly studied nursing education at the Univer-
sity of Toronto and followed 2 postgraduate
course on psychiatric nursing at the New
York Psychiatric Institute.
She gained experience in both nursing
and nursing education in the United States
and Canada. At the Presbyterian Hospital,
New York, Miss Bell served as a head
nurse. Following this she worked as an
instructor and a clinical supervisor at the
Wellesley Hospital, Toronto, and the St.
Catharines General Hospital, St. Catharines,
Ontario.
Back in the United States, at Durham,
North Carolina, Miss Bell worked as coor-
dinator for a school for colored practical
nurses at Duke University School of Nurs-
ing.
Prior to her present appointment at the
General and Marine Hospital, Miss Bell
was director of nursing service at the
Public General Hospital, Chatham, Ontario.
1r'-
Diane Yvonne Ste-
wart, of London, On-
tario, received a
double appointment
recently from the
London Health As-
sociation and the
University of Western
Ontario. She was ap-
pointed director of
nursing service at the new University Hos-
pital and also an associate professor, part-
time, in the University of Western Ontario
School of Nursing.
Miss Stewart obtained her B.Sc.N. from
Western and is currently completing re-
quirements there for a master of science
in nursing degree. A Canadian Nurses'
Foundation Fellowship was awarded to
Miss Stewart for 1966-67.
Following graduation from Victoria Hos-
pital School of Nursing in London, Miss
Stewart attended the University of Toronto
for one year. She then taught obstetrical
nursing at the Victoria Hospital School of
Nursing for two years. At that time she
became a supervisor in the nursing service
department and later assistant director of
nursing at Victoria Hospital.
Joanne Fyle, St. Thomas, Ontario, has
been awarded the RNAO entrance bursary
at McMaster University School of Nur-
sing.
Sharon Hanna, Dunnville, Ontario, has
won the Niemeier Scholarship for high
standing in third year maternal and child
care nursing.
Elizabeth Latimer, Hamilton, Ontario,
is winner of the McGregor Clinic Scholar.
ship for high set standing in third year
medical-surgical nursing.
Nancy Mcllwraith, Marathon, Ontario,
has won the Niemeier Scholarship for
highest standing in first and second year
clinical nursing subjects.
Irene Ashworth,
former supervisor of
the Ottawa Branch of
the Victorian Order
of Nurses, recently
joined the national of-
fice staff as a regional
supervisor.
Miss Ashworth, a
graduate of the School
of Nursing of St. Joseph's Hospital, Hamil-
ton, Ontario, also holds a diploma in pub-
lic health which she earned in 1959 from
MARCH 1%7
the University of Western Ontario and a
diploma in supervision and administration
from the University of Toronto.
Before joining the Victorian Order of
Nurses in 1957, Miss Ashworth did generaJ
and private duty nursing at the Hamilton
Civic Hospital and St. Joseph's Hospital,
Hamilton, Ontario. She served as a staff
nurse with the Hamilton Branch of the
V.O.N. until 1963. The following year she
became supervisor of the Ottawa Branch
where she remained until her present ap-
pointment as a regional supervisor.
Lillian Mae Randall, a native of Van-
couver, British Columbia, also joined the
national office of the Victorian Order of
Nurses as a regional supervisor.
Miss Randall graduated from the School
of Nursing of the Vancouver General Hos-
pital in 1945 and served for one year as a
staff nurse in the psychiatric ward of the
same hospital.
The following year she obtained her
certificate in public health nursing from
the University of British Columbia.
In 1947 Miss Randall became a staff
nurse for the Vancouver Branch of the
V.O.N., and later the educational super-
visor for the Vancouver Branch.
In 1963 she obtained a certificate in
public health administration and supervi-
sion from the University of Toronto.
At the end of 1966, Margaret E. Mac-
donald retired from service at the Calgary
General, the hospital she entered as a
student nurse over 40 years ago.
Born in New Brunswick, Miss Mac-
donald came to Western Canada in 1919
and entered the Calgary General Hospital
School of Nursing in 1923. After her grad-
uation in 1926, she began her career at the
hospital. She gained experience as a staff
nurse, private duty nurse, head nurse and
nursing supervisor.
At retirement she was evening supervisor
in the convalescent-rehabilitation building
of the hospital.
Known affectionately as "Black Mac"
since her school days, Miss Macdonald is
"a person who always places others first."
At the open house reception given in her
honor before her retirement, Miss Mac-
donald's 37 years of continuous service at
the Calgary General Hospital were recogniz-
ed by members of the hospital board and
medical staff.
Florence Taylor, associate director of
nursing education, Brantford General Hos-
pital since August, died suddenly Decem-
ber 19, 1966.
Her nursing experience has taken her
through Canada, the United States, India,
Korea, and Manchuria.
Miss Taylor joined the staff of Brant-
MARCH 1967
I
.... ./'-'
-
,
- f J.. \1
"
'"'
, ,
,
--
Enaam Abou-Youssef, an instructor from the United Arab Republic, dIscusses
CNA's public relations program with June Ferguson, public relations officer.
On the homeward swing of a journey
that began in February 1961, Enaam Y.
Abou-Youssef visited CNA House in Ot-
tawa, Wednesday, January 18, 1967.
Miss Abou- Youssef, a nurse from the
United Arab Republic, attended the Uni-
versity of California School of Nursing
where she obtained her master of science
degree in 1963. She then enrolled in the
doctoral program at Teachers College,
Columbia University in New York.
Miss Abou-Youssef is from Alexandria,
Egypt. In 1960, she was in the second
class to graduate from the first university
nursing course established in the UAR at
the Higher Institute of Nursing, University
of Alexandria. Following this she was ap-
pointed clinical instructor at the same
institution.
Miss Abou- Youssef said that the establish-
ment of university schools of nursing in
the UAR brought "more prestige and sta-
tus" to the profession in her country.
Miss Abou- Youssef is presently working
on her doctoral project - a thesis on
maternity nursing "focused on the respon-
sibilities of the nurse to the family during
the maternity cycle." She hopes that the
thesis eventually will be translated into
Arabic and published as a textbook to be
used by the baccalaureate students in the
Near Eastern Region.
The book will be entirely new in its
approach to maternity nursing as it does
not include anatomy and physiology of re-
productive organs or the mechanism of labor
as complete units.
During her visits to the Universities of
Manitoba and Western Ontario, Miss Abou-
Youssef gathered ideas for developing a
different point of view for the master's
program to be inaugurated at the University
of Alexandria.
On her return home this spring she will
teach maternity nursing at the Higher In-
stitute of Nursing. She is also involved
in developing nursing activities, nursing
education and nursing service throughout
her country.
Miss Abou-Youssef also admits she looks
forward "to being waited on again" when
she returns to her homeland.
ford General Hospital, January 1966 as
assistant director of nursing education.
Canadian-born Helen Young, a widely
known figure in American nursing, died
recently at 92.
Miss Young taught in an Ontario public
school for 13 years before she entered the
Presbyterian Hospital School of Nursing,
New York, in 1909. In World War I she
served at a hospital for the wounded in
Juilly, France.
In 1921, nine years after Miss Young
became a nurse at the Presbyterian Hospi-
tal, she succeeded Miss Anna C. Maxwell,
the school's first director.
In 1933 Miss Young became the first
editor of Quick Reference Book for Nurses,
and in 1937 she received Columbia Uni-
versity's medal for excellence, awarded
for service to the university.
William A. Holland, administrator of the
Oshawa General HospitaJ, was recently
elected president of the Ontario Hospital
Association for 1966-67. Mr. Holland has
been a member of the Association's board
of directors since 1959. As the first admi-
nistrator to hold the top OHA post in five
years, Mr. Holland succeeds Glen W. Phelps,
a trustee of the OriIlia Soldier's Memorial
HospitaJ.
THE CANADIAN NURSE 19
..
your
Own
hands:
....
.
"
"'
soft testimony to your patients' comfort
Your own hands are testimony to Dermassage's effectiveness. Applied by your
soft, practiced hands, Dermassage alleviates your patient's minor skin irritations
and discomfort. It adds a welcome, soothing touch to tender, sheet-burned
skin; relieves dryness, itching and cracking. . . aids in preventing decubitus
ulcers. In short, Dermassage is "the topical tranquilizer", , . it relaxes the patient
. , , helps make his hospital stay more pleasant.
You will like Dermassage for other reasons, too. A body rub with it saves your time
and energy. Massage is gentle, smooth and fast. You needn't follow-up with
talcum and there is no greasiness to clean away, It won't stain or soil linens or
bed-clothes. You can easily make friends with Dermassage-send for a sample!
Now available in new, 16 ounce plastic container with convenient flip-top closure.
--.
,
.....
"
tr A
.....-
N._ .....
Im8SS8P
...., rei""'"
...,--
'-II"
r
LdL
MEDICATED
ilin
U]
e'
.TIIU,DfMAIiK
c:5Ø LAKESIDE LABORATORIES (CANADA) LTD.
64 Colgate Avenue. Toronto 8, OntarIo
MARCH 1967
20 THE CANADIAN NURSE
in a capsule
Wine - the Chemical Symphony
"Have a glass of this therapeutic adju-
vant for the promotion of relaxation," your
medicaHy-minded host may suggest some
evening after supper. If you refuse, you
may be turning down a "natura1 tranquilizer"
of some fine old vintage.
For those who need and excuse to drink
wine, Dr. Sa1vatore P. Lucia, professor of
medicine at the University of California
School of Medicine, San Francisco. provides
several sound therapeutic ones.
Wine, he points out, has been used for
more than 40 centuries as a safe tranqui-
lizer and there is no reason it should not
be used for this even today. Modem re-
search has confirmed the age-old values of
wine, he says. In his view, wine is a "natu-
ral tranquilizer" while tranquilizing drugs are
"artificia1 tranquilizers."
Wine, says Dr. Lucia, is more than merely
a1cohol. "Its many other ingredients bring
it into the category of tranquilizers. Many
studies of wine disclose that the ability of
wine to reduce nervous tension is a result
of the ability of its 'chemical symphony'"
Numerous studies have shown "that wine
gives far more sustained and gently tran-
quilizing effects than does straight ethyl
alcohol diluted with water to the same
strength. "
One leading possibility for use of wine
as a tranquilizer is in the elderly, says Dr.
Lucia. It can help them "cope with... ten-
sions and live out a long span in peace and
gratitude." One serving before a mea1 or
two servings with a meal provide the desired
tranquilization.
"In the rush of rapid pharrrulceutical pro-
gress, the ages-old established, inexpensive,
and safe medicine called wine is apt to be
forgotten," writes Dr. Lucia. "So, too, in a
post-prohibition society, these ancient dietary
beverages are still apt to be regarded over-
emotionally and pseudo-moralistically by the
physician. Yet, the long history of the use
of wine in medical practice and the modern
scientific research confirming its values are
gaining the attention of increasing numbers
of physicians."
No Utopia for Nurses
"In some Utopian tomorrow," says Mollie
'Gillen of Chatelaine, (January 1967) nurses
will be "freed at last from the tyranny of
counting sheets, serving meals, making up
empty beds and pushing wheelchairs."
Unfortunately, she sees that tomorrow as
a far distant one.
MARCH 1967
The nursing profession in Canada today,
according to Mrs. Gillen, is characterized
by "creaking mechanisms and archaic pat-
terns" which, instead of improving are act-
ing as deterrents to prospective student
nurses.
In fact, the percentage of high-school
graduates entering nursing has declined
sharply over the past twenty years. Only
10 percent of girls from high schools are
enrolling today (in 1951 it was 20 percent;
in 1944, 25 percent), and "a continued drop
is feared unless nursing is made more at-
tractive as a career," she says.
What exactly are the problems that beset
nursing today? asks Mrs. Gillen.
In answer to her own question, she places
at the top of the list the shortage of nurses
that keeps whole hospital wings closed and
overworks existing staff. She also points out
the shortage of teachers to train nurses and
the proliferation of aides and helpers whose
training and duties aren't clearly defined.
Then there are antiquated hospital schools,
where training is paid for by free labor. Not
surprising, continues the author, is the grow-
ing demand for promotion opportunities in
clinical nursing, as well as in administration
and teaching. Moreover, the profession is
beset by internal conflicts for better pay,
better working conditions and a more de-
mocratic organization.
Problems unfortunately are more plentiful
and obvious than solutions. However, an
Canadian provinces today at least recognize
the need for shortening the diploma pro-
gram, for providing opportunities for clinical
specialization, and for rearranging salary
levels.
"With solutions slowly being found to the
still-quite-bitter intramural arguments within
the profession... nursing could be at the
beginning of a new regime that safeguards
the nurses in their rights as well as the
public in its expectation of good service,"
concludes Mrs. Gillen.
5,500,000 Still Puffing
At least 1,000,000 Canadians did it. An-
other 2,500,000 seriously tried but couldn't,
and a further 3,000,000 didn't even attempt
to break the smoking habit.
Of the 1,000,000 regular cigaret smokers
who successfully overcame the habit, most
claimed "unspecified health reasons" as their
reason for quitting. Others named coughing,
throat irritation, bronchitis, family objec-
tions, expense, and doctor's orders as res-
ponsible. Low on the list came fear of
cancer.
Even those 5,500,000 brave Canadians
who steadfastly hang onto the habit despite
the odds, admit dissatisfaction with theIr
smoking habits. These findings were the re-
sults of a survey recently released by Hon.
Allan J. MacEachen, Minister of National
Health and Welfare.
The study also shows that certain pro-
vinces are more nicotine-prone than others.
Regionally, British Columbia shows the high-
est proportion of former regular smokers
(49% of male and 17% of female non-
smokers and occasional smokers were at one
time regular cigaret smokers) and Quebec
the smallest (30% of male and 8% of
female.) British Columbia also shows the
highest proportion (53%) of regular cigaret
smokers who have tried to stop smoking,
and Quebec the lowest (37%).
Conducted among persons 15 years of
age and over, the survey reveals that among
present non-smokers of cigarets, 32% of
the men and 9% of the women at one time
were regular users. Attempts to break the
smoking habit tend to be more common
among those under 40. Women who have
succeeded are most commonly found in the
20 to 39 age bracket. Men who have stopped
daily smoking are more frequently found
among those 40 and over.
A growing awareness of the dangers of
cigaret smoking is reflected in the concern of
the Department of National Health and
Welfare with the smoking habits of Cana-
dians. Annual surveys and comparisons of
results are planned by the Department for
the future.
Vaccine Race
A live vaccine against mumps appears
to have been developed simultaneously -
or almost simultaneously - in the East and
in the West.
The Russians claim that the first one was
developed at the Pasteur Institute in Lenin-
grad. This vaccine was tried out among all
the children aged two to twelve in Pskov a
regiona1 center nearby. There were onl; a
few cases in the year following the vaccina-
tion, although there had been mass out-
breaks in the same region previously.
In the U. S. a live attenuated vaccine
(developed by Dr. Maurice R. Hillman and
Dr. Eugene Buynak) was tested among 482
Philadelphia school children. A great many
cases of natura1 mumps occurred in the test
community, whereas there were only two
cases - both in school-age youngsters -
among the vaccinated children. - Royal
Society of Health Journal - Sept.-Oct.
THE CANADIAN NURSE 21
new products
{
Descriptions are based on information
supplied by the manufacturer and are
pro
ided only as a service to readers.
Specimen Container
(PROFESSIONAL DISPOSABLE PRODUCTS)
Description - A water-tight and odor-
proof, eight-ounce laboratory specimen
container made of shatterproof, opaque
plastic. This container is supplied with a
specially imprinted lid which simplifies
writing identifying information.
For additional information, write to
Professional Disposable Products, Inc., 22-
28 South Sixth Avenue, Mount Vernon,
New York 10550.
1
&
,,'ORY SP.Fc/..
.$'. _ "'t;..
Norlestrin 1 mg.
(PARKE-DAVIS)
Description - A new, low-dosage (1.0
mg.) form of the oral contraceptive, Norl-
estrin, previously available only as a 2.5
mg. tablet. Each tablet of Norlestrin 1 mg.
contains norethindrone acetate I mg. and
ethinyl estradiol 0.05 mg.
Norlestrin I mg. is a progestogen-
estrogen combination for control of con-
ception. Like Norlestrin 2.5 mg., it contains
norethindrone acetate and ethinyl estradiol
but it contains only 1 mg. of the proges-
togen.
Dosage - Initial cycle: The first tablet
is taken on the fifth day after onset of
menstruation. The first day of menstrual
flow is considered day one. Tablets should
be taken regularly with a meal or at bed-
time. After taking one tablet daily for 21
consecutive days, no tablets are taken for
7 days. Subsequent cycles: After the 7-day
interval in which no tablets are taken, a
neW course of 21 tablets is started regard-
less of whether bleeding has finished or
not. Each cycle consists of 21 days of
medication and a 7-day interval without
medication.
Contraindications - This type of ther-
apy (progestogen-estrogen combinations) is
contraindicated in patients with, or with a
history of, cancer (because of the estro-
gen), preexisting liver disease, or a history
22 THE CANADIAN NURSE
of thromboembolic disorder. Oral contra-
ceptives should not be used by nursing
mothers, young women in whom epiphyseal
closure is not complete, or women who
have had a stroke, partial or complete loss
of vision, diplopia or proptosis. The use of
oral contraceptives containing progesta-
tional agents should be avoided where preg-
nancy is suspected.
Side Effects - Break through bleeding,
nausea, and diminished menstrual flow are
the principal side effects considered to be
drug related.
For further information or to obtain the
file booklet containing the basic prescrib-
ing information, write Parke, Davis &
Company, Ltd., P.O. Box 2100, St. Laurent
Post Office, Montreal 9, P.Q.
Flexitone
(CYANAMID)
Description - A new adjustable surgical
binder for use with postoperative and post-
partum patients. The Flexitone binder is
designed to provide comfortable support
without compromise of muscle tone. It will
not roll, ride or chafe and provides enough
"give" to allow freedom for the muscles to
expand and contract.
The binders are anatomically designed
and sized for both male and female patients.
They are lined for comfort and may be
laundered repeatedly without loss of resi-
liency.
Uses - The Flexitone surgical binder is
used after abdominal surgery, after normal
delivery or caesarian section, for chest sup-
port in fractures and surgery, and for back
support.
Cerevon-S
(CALMIC)
Description - Cerevon-S is a combina-
tion of ferrous succinate 150 mg. and suc-
cinic acid 110 mg.
Indications - Used in the treatment of
iron deficiency anemia. Compared to
other methods of treating iron deficiency
anemia, Cerevon-S showed a more rapid
rate of hemoglobin rise and a higher final
hemoglobin level after twenty weeks. It is
also effective in some patients who do not
respond to conventional oral iron.
Dosages - One capsule t.Ld. between
meals or as prescribed. When given be-
tween meals, the period of maximum ab-
sorption, Cerevon-S produces minimal intol-
erance, although gastrointestinal disturb-
ances, eg., diarrhea, constipation, heart-
burn, can occur.
For further information, contact Calmic
Limited, 16 Curity Avenue, Toronto 16,
Onto
Ger-o-Foam
(WINLEY-MORRIS)
Description - Benzocaine 3%, methyl
salicylate 30%, in a neutralized emulsion
base containing volatile oils.
Indications - Ger-o-Foam is an anesthe-
tic analgesic foam used to increase mobility
of limbs in musculo-skeletal involvements.
The formulation permits penetration of
the medicaments into the deeper structures
underlying the skin to relieve pain and
stiffness in rheumatoid and osteoarthritis;
painful limbs following cerebrovascular
accident; painful healed fracture, low back
pam; sprains; etc.
Directions - Apply to affected part
and massage in gently.
For information contact: Winley-Morris
Co. Ltd., 2795 Bates Rd., Montreal 26, P.Q.
Tussagesic
(ANCA)
Description - Each time-release tablet
contains triaminic 50 mg., dormethan
30 mg., terpin hydrate 180 mg., and aceta
minophen 325 mg.
Indications - For relief of symptoms of
the common cold. Tussagesic decongests,
relieves pain, breaks up cough and provides
effective expectorant action.
Dosages - For adults and children over
12 years - one tablet, swallowed whole,
in morning, mid-afternoon and at bedtime.
Tussagesic is also available in suspension
form. Both tablets and suspension can
cause occasional drowsiness, blurred vision.
cardiac palpitations, flushing, dizziness,
nervousness or gastrointestinal upsets.
For further information, contact ANCA
Laboratories, 1377 Lawrence Ave., East,
Toronto, Ontario.
MARCH 1967
dates
April 27-29, 1967
Registered Nurses' Association of Ontario,
annual meeting. Royal York Hotel,
Toronto.
May 4-6, 1967
St. Boniface Hospital, School of Nursing,
25th Reunion of the 1942 Graduating
Closs. Would members of the 1942
graduating closs please write to
Miss F.E. Taylor, R.N.,
10123-122 Street, Edmonton.
May 8-12, 1967
Notional League for Nursing, Biennial
Convention. Theme: "Nursing in the Health
Revolution." New York Hilton Hotel,
New York City.
May 16-19, 1967
Alberto Association of Registered Nurses
Annual Meeting, Chateau Lacombe,
Edmonton, Alberto.
May 19-21, 1967
60th Anniversary reunion of the Royal
Inland Hospital School of Nursing,
Kamloops, B.C. For further information
write: Mrs. Sylvia Lum, Suite "C",
248 Victoria St., Kamloops, B.C.
May 24-26, 1967
Saskatchewan Association of
Registered Nurres Annual Meeting.
Saskatoon.
May 24-26, 1967
International Symposium on Electrical
Activity of the Heart, London, Ontario.
For further information write to
Dr. G.W. Manning, Victoria Hospital,
London, Onto
May 29-31, 1967
Operating Room Nurses' Fourth Ontario
Conference, The Inn on the Park,
Toronto, Ont. Sponsored by the Operating
Room Nurses of Greater Toronto. Direct
inquiries to: Mrs. Eleanor Conlin, R.N.,
437 Glen Pork Avenue, Apt. 309,
Toronto 19, Onto
May 31-June 2, 1967
Registered Nurses' Association of Novo
Scotia Annual Meeting, Sydney, N.S.
MclY 31-June 2, 1967
Registered Nurses' Association of British
Columbia Annual Meeting, Bayshore Inn,
Vancouver, B.C.
MARCH 1967
May 31-June 2, 1967
New Bn.mswick Association
of Registered Nurses Annual
Meeting. The Playhouse, Fredericton.
June 4-16, 1967
University of Windsor, 6th annual
residential summer course on alcohol and
problems of addiction. Co-sponsored by
the University of Windsor and the Alcohol
and Drug Addiction Foundation of Ontario.
Limited enrollment. Enquiries to: Director,
Summer Course, Addiction Research
Foundation, 24 Harbord St., Toronto 5, Onto
June 5-8, 1967
Atlantic Provinces Hospital Association,
Annual Meeting.
June 8-9, 1967
Manitoba Association of Registered
Nurses' Annual Meeting to be held
in connection with the Western Regional
Hospital Conference
June 12-15 1967
Canadian Dietetic Association, 32nd
Convention, Château Laurier, Ottowa.
June 18-21, 1967
Ottowa Civic Hospital, Centennial Home
Coming. Alumnae or former associates of
the Ottowa Civic Hospital who are
interested in the program should write to:
Executive Director, Ottowa Civic Hospital.
June 24, 1967
St. Joseph's Hospital School of Nursing,
Toronto, Centennial Reunion. Any graduates
who do not receive alumnae newsletters,
please send nome and address to:
St. Joseph's Hospital School of Nursing
Alumnae, 30 The Queensway, Toronto 3,
Ontario.
July, 1967
75th Anniversary, Nova Scotia Hospital
School of Nursing, Dartmouth, N.S. All
interested graduates please contact
Mrs. G. Varheff, 20 Ellenvale Ave.,
Dartmouth, N.S.
September 15-17, 1967
70th Anniversary, Aberdeen Hospital School
of Nursing, New Glasgow, Novo Scotia.
Write: Mrs. Allison MacCulioch, R.R. #2,
New Glasgow, Pictou Co., Novo Scotia.
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THE CANADIAN NURSE 23
Plan Now For
Basic Sciences
BASIC PHYSIOLOGY AND ANATOMY
By Ellen E. Chaffee, R.N., M.N., M. Lilt.; and Esther
M. Greisheimer, Ph.D., M.D.
Physiology and anatomy are skillfully fused in this text
designed for the freshman nursing student. Realistic
clinical applications clarify scientific principles. Chap-
ters are amplified by summaries and questions. Testing
program for instructors' use is available upon request.
656 Pages 371 lIlustrations, 45 in color, plus Videograf
1964 $7.75.
LABORATORY MANUAL IN
PHYSIOLOGY AND ANATOMY
By Ellen E. Chaffee, R.N., M.N., M. Lilt.
Organized into twenty-four laboratory units with em-
phasis on the normal human body. Practical applica-
tions animate the principles. Study questions follow
each lesson. 260 Pages lIlustrated 1963 $2.60.
PHYSIOLOGY AND ANATOMY:
With Practical Considerations
By Esther M. Greisheimer, Ph.D., M.D.; with the
assistance of J. Robert Troyer, Ph.D.
A text designed to meet the needs of students in general
courses as well as those directly applied to nursing.
Physiology and anatomy are featured in separate chap-
ters according to body systems. Content is enlivened
by practical considerations pertaining to broad health
problems. 894 Pages 430 lIlustrations, plus Videograf
8th Edition, 1963 $9.50.
ESSENTIALS OF CHEMISTRY
By Gretchen O. Luros, M.A.; and Jack C. Towne,
Ph.D.
Provides the student with a strong foundation in inor-
ganic, organic and particularly physiologic chemistry.
New data incorporated in the 7th Edition includes car-
bohydrates, lipids, proteins, metabolism, nucleic acids,
enzymes, vitamins, inorganic body requirements and
hormones. 356 Pages 101 lIlustrations 7th Edition,
1966 $6.50.
INTRODUCTION TO MEDICAL PHYSICS
By J. Trygve Jemen, Ed. D.
A clarification of the physical principles underlying
nursing procedures and an explanation of the scientific
framework upon which qualified nursing activities de-
pend. Virtually all the basic laws of physics employed
in nursing are discussed. 240 Pages 139 lIlustrations
1960 Paperbound $3.75.
BASIC MICROBIOLOGY
By Margaret F. Wheeler, R.N., A.M.; and Wesley A.
V olk, Ph.D.
A clear and concise introduction to the basic aspects
of microbiology. Coverage includes: discussions of
bacteria, protozoa, viruses, rickettsiae and other micro-
organisms and their relevance to health and disease.
Pathogens are grouped according to portal of entry,
in reldtion to body systems. Chapter summaries, ques-
tions, illustrations and charts contribute to overall
clarity. 389 Pages 163 lIlustrations 1964 $6.25.
NUTRITION IN HEALTH AND DISEASE
By Lenna F. Cooper, Sc.D.; Edith M. Barber, M.S.;
Helen S. Mitchell, Ph.D., Sc.D.; and Henderika J. Ryn-
bergen, M.S.; with the assistance of Jessie C. Greene,
B.S.
Because of vigorous streamlining, this book has gained
in versatility both as a text for basic nutrition courses
and for diet therapy. The 14th Edition includes up-to-
date tables, bibliography, and an expanded glossary.
615 Pages 101 lIlustrations 14th Edition, 1963 $7.50.
Clinical Nursing
SCIENTIFIC FOUNDATIONS OF NURSING
(Formerly Science Principles Applied to
Nursing)
By Madelyn T. Nordmark, R.N., M.S.; Anne W. Roh-
weder, R.N., M.N.
To bridge the gap between scientific theory and clinical
practice. This book should be in every student's hands.
It is an indispensable tool for problem solving, nursing
diagnosis, intervention, and review. About 250 Pages
2nd Edition, 1967 Paperbound, about $5.00 Cloth-
bound, about $7.00.
FUNDAMENTALS OF NURSING:
The Humanities And The Sciences In
Nursing
By Elinor V. Fuerst, R.N., M.A.; and LuVerne Wolff,
R.N., M.A.
This text is designed to give the student a sound underi
standing of the principles underlying all nursing action.
The problem-solving approach is stressed to enable
the student to act flexibly and analytically in any given
situation. Emphasis is on "core" content common to
every area of nursing practice. 661 Pages 158 lIlustra-
tions 3rd Edition, 1964 $6.50.
PROGRAMMED MATHEMATICS OF
DRUGS AND SOLUTIONS
By Mabel E. Weaver, R.N., M.S.; and Vera J. Koehler,
R.N., M.N.
Shows the student - step by step - how to apply her
basic knowledge of mathematics to the administration
of drugs and solutions. The 1966 Printing contains a
chapter on medications for infants and children. 109
Pages 1966 Printing Paperbound, $2.25.
FUNDAMENTALS OF MEDICATIONS:
Dosages, Solutions and Mathematics
By Joy B. Plein. Ph.D.; and Elmer M. Plein, Ph.D.
Uniquely keyed to current nursing practice, this new
text-workbook for Pharmacology 1 includes: sources
of drugs, dosage forms, routes of administration,
mathematics of drug administration, medication orders,
pediatric dosages and legislation regulating the use of
drugs. About 125 Pages New, 1967 Paperbound, about
$3.50.
Fall Classes
CARE OF THE ADULT PATIENT:
Medical-Surgical Nursing
By Dorothy W. Smith, R.N., Ed.D.; Claudia D. Gips,
R.N., Ed.D.
Extensively rewritten, this patient-centered textbook is
more valuable than ever to the instructor and student.
Relevant concepts from the life sciences have been
integrated throughout the text. New nursing principles
and practices created by medical progress have been
included. 1206 Pages 406 Illustrations 2nd Edition,
1966 $11.25.
TEXTBOOK OF MEDICAL-SURGICAL
NURSING
By Lillian Sholtis Brunner, R.N., M.S.; Charles Phillips
Emerson, Jr., M.D.; L. Kraeer Ferguson, M.D.,
F.A.C.S.; and Doris Smith Suddarth, R.N., M.S.N.
This comprehensive textbook of nursing care provides
a wealth of information and an intelligent understand-
ing of every patient regarding altered physiology, signs
and symptoms, management of his condition and
problems, appreciation of emotional state and rehabili-
tation. 1198 Pages 509 Illustrations, 48 in color 1964
$12.50.
PATIENT STUDIES IN MEDICAL-
SURGICAL NURSING
By Jane Secor, R.N., M.A.
Twenty-six patient studies focus on patients as persons
who have major medical or surgical problems, and who
require creative nursing care. The author skillfully
interweaves ethics, the hospital milieu, legal implica-
tions, interpersonal relationships, psychosocial aspects,
and the family. About 400 Pages New, 1967 Paper-
bound, about $5.25.
BASIC PSYCHIATRIC CONCEPTS
IN NURSING
By Charles K. Hof/ing, M.D.; Madeleine M. Leininger,
M.S.N., Ph.D.; and Elizabeth A. Bregg, R.N., B.S.
Advances in psychiatry with implications for increased
nursing responsibilities are reflected in this new edition.
Problem-solving, process recording and short and
long-term nursing goals are stressed. Nurse-patient in-
teraction is clarified by patient studies. Helpful sum-
maries follow each chapter. About 575 Pages 2nd Edi-
tion, 1967 About $7.00.
PATIENT STUDIES IN MATERNAL
AND CHILD NURSING:
A Family-Centered Student Guide
By Ann L. Clark, R.N., M.A.; Hella M. Hakerem,
R.N., M.A.; Stephanie C. Basara, R.N., M.A.; and
Diane A. Walano, R.N., M.A.
Designed for integrated maternal-child nursing courses,
this book also correlates effectively where obstetrics
and pediatrics are taught separately. Realistic patient
situations enable the student to identify the nursing
needs of mothers and children and to plan nursing
action based on her knowledge of the sciences. 305
Pages 1966 Paperbound, $5.00 Clothbound, $7.25.
MATERNITY NURSING
By Elise Fitzpatrick, R.N., M.A.; Nicholson J. East-
man, M.D.; and Sharon Reeder, R.N., M.S.
Family-centered throughout, the II th Edition has been
brought completely up-to-date. "This is the book for
which we have been waiting," writes one instructor,
"it is readable, the illustrations are excellent, and the
family-centered approach is of infinite value." 638
Pages 311 Illustrations I I th Edition, 1966 $8.00.
ESSENTIALS OF PEDIATRIC NURSING
By Florence G. Blake, R.N., M.A.; and F. Howell
Wright, M.D.
Offers the student a rich source of material on all
phases of the nursing of children, i.e., how to recog-
nize, understand, appreciate and meet the emotional,
physical and social needs of the child. Presented ac-
cording to age levels from birth to adolescence. 815
Pages 237 Illustrations 7th Edition, 1963 $8.00.
FOUNDATIONS OF PEDIATRIC NURSING
By Violet Broadribb, R.N., M.S.
A "shorter" presentation, confined to the cardinal prin-
ciples involved in the nursing of children. In this new
text the author provides commonsense guidance and
specific suggestions for nursing action. Content is struc-
tured according to age groups. About 600 Pages 1967
Paperbound, about $5.00 Clothbound, about $7.50.
For Senior Seminars
SOCIAL INTERACTION AND
PATIENT CARE
Edited by James K. Skipper, Jr., Ph.D.; and Robert C.
Leonard, Ph.D.
This well-researched book of readings serves as a link
between the social sciences and clinical practice. Its
35 articles, accompanied by editorial commentary, deal
with the nurse's role, communication, the patient's
view, structural and cultural environment, and role
conflicts. 400 Pages 1965 Paperbound $4.75.
PROFESSIONAL NURSING
Foundations, Perspectives and
Relationships
By Eugenia K. Spalding, R.N., M.A., D.H.L.; and
Lucille E. Notter, R.N., Ed.D.
This text presents the student with the essential final
step in the process of evolving into an independently
thinking and acting professional person, with a broad
view of the traditions, trends, opportunities and chal-
lenges of nursing. 684 Pages 75 Illustrations 7th Edi-
tion, 1965 $8.50.
-:::LiPPincot
60 FRONT STREET WEST, TORONTO 1, ONTARIO
Katherine E. MacLaggan
A Tribute
Katherine E. MacLaggan, president of the Canadian Nurses' Association,
and director of the School of Nursing, University of New Brunswick, died
February 6, 1967, in Saint John, New Brunswick.
Her death brings to an end a career that provided outstanding leadership in
Canadian nursing.
Dr. MacLaggan was born in Fredericton, N.H., and received her early
education and preparation as a teaoher in that city. Becoming interested in
nursing, she entered the School of Nursing of the Royal Victoria Hospital.
Montreal, and graduated in 1943. Following this, she enrolled in the McGill
School for Graduate Nurses and obtained a diploma in public health nursing in
1945. Two years later she returned to the same institution to complete require-
ments for the degree of baohelor of nursing.
In 1957 she obtained a master of arts degree from Teachers College,
Columbia University, and in 1965, a doctor of education degree from the same
university.
Dr. MacLaggan's professional experience includes staff positions at the
Royal Victoria Hospital, in industry, and in the public health nursing service
of the New Brunswick Department of Health. Prior to her appointment as the
first director of the University of New Brunswick Sohool of Nursing in 1958,
she was assistant director of public health nursing in the province and a faculty
member of Teachers' College, Fredericton.
Some nurses will remember Katherine MacLaggan as a capable, humanistic
practitioner of nursing. Others will remember her as a superb teacher, an able
administrator, an understanding counselor, and a gentlewoman of great integrity,
courage, and strength of purpose.
Many nurses of today and of future generations will remember Katherine
MacLaggan for her perceptive observations and sound recommendations
concerning nursing education. Her brilliant dissertation Portrait of Nursing:
A Plan for the Education of Nurses in the Province of New Brunswick, in
which she lucidly and forcefully set forth her philosophy of nursing and nursing
education, has already provided a goal for educators in her native province. It
is being examined with interest by educators in other provinces.
Those who knew Katherine MacLaggan well, will remember her as a person
first, and as a nurse second. She gave much of herself to many. She was never
too busy to listen to a colleague's problems over a cup of coffee, or to take a
visitor on a guided tour of her home city, Fredericton, of which she was so
proud.
In her Acceptance Address as newly-elected President of the Canadian
Nurses' Association last July, Dr. MacLaggan stated: "You have a right [as
CNA members] to demand that your president has integrity, will offer a leader-
ship subject to guidance, and will make decisions and bear the consequences...."
This integrity she had. This leadership she gave.
The President continued: "Our conflict no longer concerns the problems
themselves; it concerns the status quo versus change. It is a delusion to think
that change can be avoided... The luxury of delay has disappeared. I ask you
to provide, on every occasion, what is necessary to the implementation of an
idea whose time has come.
"If decisions, or policies, or laws, or persons prove to be inadequate to the
ongoing scheme of things, remember that these are not forever and can be
changed at the next time of decision taking. What remain forever are: intellectual
honesty, values, courage, action and results."
This was her philosophy.
26 THE CANADIAN NURSE
MARCH 1967
\
.
. .
MARCH 1967
THE CANADIAN NURSE 27
Telegrams Expressed Grief...
Immediately following the untimely death of Katherine E. MacLagsan,
President of the Canadian Nurses' Association, many expressions of sympathy
were received at National Office.
From individuals
"Our sympathy and prayers go out to you. .. at this
sad time. Katherine's great contribution to nursing in
Canada will remain always a tribute to her name. -
Penny Stiver." (Former Executive Director, Canadian
Nurses' Association.)
". . . I share your sorrow. At the same time, I asso-
ciate myself with wider groups in nursing nationally and
internationally, in grateful tribute to Katherine E. Mac-
Laggan's magnificent contribution in leadership, vision,
and courage. - Dorothy Percy, Ottawa." (Former Chief
Nursing Consultant, Department of National Health and
Welfare.)
"To the nurses of Canada, deepest sympathy on the
great loss in death of your President. - Lucy D. Ger-
main, Assistant Director, Pennsylvania Hospital, Phila-
delphia." (Former Executive Director of the American
Journal of Nursing Company.)
From hospital and university staff
"On behalf of all nursing staff... we convey... our
profound regret at the loss of Dr. Katherine E. Mac-
Laggan, our National President. We were keenly aware of
and proud of her professional stature. For those now
entrusted with providing continuity for the task to which
she brought such distinction, we offer our deepest sym-
pathy and support. - Helen D. Penney, Director of
Nursing, Central Newfoundland Hospital, Grand Falls,
Nfld."
"Sincere condolences on the death of Dr. Katherine E.
MacLaggan, CNA President. Miss R. Cunningham,
Director, School of Nursing, St. Paul's Hospital, Van-
couver, B. C."
"Please accept our sincere condolences on the death
of our Association President, Dr. Katherine E. MacLag-
gan. - Faculty, Misericordia School of Nursing, Win-
nipeg, Manitoba."
"The Faculty and Students. . . extend. . . to the Can-
adian Nurses' Association their sincere sympathy in the
loss of one who has contributed so much to nursing. -
Lillian Brady, Director of Nursing Education. Halifax
Infirmary School of Nursing, Halifax, N.S."
"Personnally and on behalf of the nursing staff of
the University of Alberta Hospital, I extend sincere
sympathy. - M. Geneva Purcell, Director of Nursing.
University of Alberta Hospita1."
"The board and staff... express their sympathy to
the Canadian Nurses' Association in the death of their
president, Dr. Katherine E. MacLaggan. - Director of
Nursing. Moose Jaw Union Hospital, Moose Jaw, Sask."
"Very sensitive to your loss. Sympathy and prayers.
- Sister Françoise Robert and Faculty, School of Nurs-
ing, University of Ottawa."
From government personnel
"We join the nurses of this and other countries in
28 THE CANADIAN NURSE
paying tribute to Katherine MacLaggan. We join her
friends and family in gratitude for her life and in sorrow
for her death. Our sincere sympathies. - Senior Nursing
Officers of the Department of National Health and
Welfare."
"The Deputy Minister and Officials of the Department
of Health join me in extending to you. .. sincere con-
dolences on your great loss. - Stephen H. Weyman,
M.D., Minister of Health, Province of New Brunswick."
"Most sincere regrets from administrative and nursing
staff on death of Dr. Katherine E. MacLaggan. Her
efforts in the field of nursing will exert a lasting influence
in Canada and internationally. - O.H. Curtis, M.D.,
C.M., D.P.H., Deputy Minister of Health, Province of
Prince Edward Island."
From associations
"Sincere condolences. .. Katherine MacLaggan was a
great lady and a distinguished leader in Canadian nurs-
ing. - President and Members, Association of Nurses
of the Province of Quebec."
"Our heartfelt sympathy on the death of Dr. Kathe-
rine E. MacLaggan. - Nurses of the Labrador City
Wabush Chapter, Labrador."
"Deeply regret to learn of the death of your Presi-
dent. Dr. Katherine MacLaggan was a most dedicated
educator and leader. Her presence will be surely missed.
- Chaiker Abbis, President, Canadian Hospital As-
sociation."
"Regret untimely passing of Katherine E. MacLaggan
who made unique contribution to nursing education and
the national organization. - M.T. MacFarland, M.D., Re-
gistrar, College of Physicians and Surgeons, Winnipeg,
Manitoba. "
"The deepest regrets of our Association on the death
of your President. - W.C. Sinnott, Secretary, Hospital
Association of Prince Edward Island."
"The ANA grieves with you over the untimely death
of Katherine E. MacLaggan, well known to us for her
forward-looking and progressive leadership in nursing.
We extend our deepest sympathy with the sad realiza-
tion that your loss is our loss too. - Judith G. Whitaker,
Executive Director, American Nurses Association, New
York. "
"Deepest sympathy to the Canadian Nurses' Associa-
tion and to all Canadian nurses on the death of Presi-
dent Katherine E. MacLaggan. Am notifying ICN mem-
ber associations. - Sheila Quinn, Deputy Executive
Director, International Council of Nurses, Geneva, Swit-
zerland. "
"The members of the Association of Nurses of Prince
Edward Island share with you at CNA Headquarters
a great personal loss in the early death of our President,
Dr. Katherine E. MacLaggan. - Helen L. Bolger,
Executive Secretary Registrar, ANPEI."
MARCH 1967
The disparity in health standards bet-
ween the Arctic and southern Canada
has prompted a committee of the Cana-
dian Pediatric Society to study the
Eskimo health problems, and to make
suggestions as to how pediatricians can
cooperate with and support the pro-
grams presently being carried out by
the Northern Health Services of the
Department of Health and Welfare. As
a result, in July of 1965, The Montreal
Children's Hospital started to send a
senior pediatric resident each month
to serve in the new 28-bed hospital at
Frobisher Bay, Baffin Island.
A harsh land
The health problems of the arctic
must be considered in relation to th\':
geography, climate, and the history of
its people. The 1,253,000 square miles
of land comprising the Northwest Terri-
tories equal the combined area of the
Atlantic Provinces, Quebec, Ontario,
and Manitoba. Distance alone creates
a problem in survival. In the Eastern
Arctic (Baffin and Ellesmere Islands)
Precambrian rocks form mountains,
often divided by glaciers, which rise to
10,000 feet and fall in spectacular
cliffs into majestic fjords. The vegeta-
tion consists only of lichens, mosses
and a few shrubs.
In this land, the dog sled or skidoo
is useful only on the coastal areas
during the winter. Effective transporta-
tion of men and materials depends on
the airplane in winter, and on coastal
vessels during the short summer.
MARCH 1967
Medical care of
Eskimo children
Small northern hospitals now have something new - a pediatric resident.
N. Steinmetz, M.D.
During break-up and freeze-up most
transportation comes to a standstill,
although some of the larger settlements
have landing strips on firm soil. Radio
is still the chief means of communica-
tion.
The climate makes severe demands
on housing and clothing. Great skill is
required to live off the land. Between
November and February it is genuinely
cold, the temperature falling to minus
30-40 degrees F, and only in June,
July and August does the average tem-
perature rise to 40-45 degrees F. Strong
winds and blowing snow are the chief
hazards in overland travel.
A hard life
Traditionally, all the Eskimos lived
along the coast in family units, and
moved to follow the game upon which
their survival depended. Starting as
early as 1000 A.D., but mainly between
the sixteenth and eighteenth centuries,
they had increasing contact with white
explorers. During the 1800's they dealt
with whalers, fur traders, and mission-
aries. Gradually they settled near
trading posts as the latter developed,
and sought employment there. The
white man established these settlements
according to criteria that satisfied his
own requirements.
The town of Frobisher Bay, for ex-
ample, was never an Eskimo settle-
Dr. Steinmetz is pediatric resident at The
Montreal Children's Hospital, and particip-
ated in the program at Frobisher Bay.
ment. In 1914 the Hudson Bay Com-
pany established a trading post else-
where on the Bay. In 1942, the United
States built a military airfield in Fro-
bisher, obviously because it was a good
place to have an airfield, not because
the area was a good hunting ground.
Of the approximately 3,000 Eskimos in
the Eastern Arctic, nearly one-half of
them now live in Frobisher Bay, which
is for them an artificial location. Here,
as in other such settlements, the men
find little opportunity to use their
special skills for hunting and arctic
survival. Consequently these skills are
as foreign to the new generation as
they are to us. The Royal Canadian
Mounted Police now teach Eskimo
Boy Scouts how to make igloos.
Education, as we know it, is now
being provided to children, but the
percentage of the population over 15
years of age without schooling is re-
markably high - 34 percent in the
North West Territories compared with
1.4 percent in the rest of Canada.! The
birth rate is more than twice that of
the rest of Canada; the under-four-
years age-group comprises the largest
group of the Eskimo population in the
Eastern Arctic. Hence the interest of
Canadian pediatricians in improving
the medical care of these people.
Pediatric care essential
The economic situation is such that
a bare, prefabricated, one-room dwel-
ling (4 walls, 1 roof, 2 windows) costs
$1000, a gallon of fuel oil costs 60ç, a
THE CANADIAN NURSE 29
30 THE CANADIAN NURSE
--.......
#
J
,
.
'-
gallon of water 1
. The per capita
income of the northern Eskimo is $426
per year compared to $1,734 for the
rest of Canada.:! Under these conditions
it is difficult to build an environment
conducive to good health. Diseases that
could be prevented by education, im-
proved living standards, and accessibili-
ty of treatment still take a huge toll in
life.
The task of providing effective me-
dical care to this scattered population
is presently being attempted by the 28-
bed Frobisher Bay Hospital under three
doctors, by the 28-bed missionary
hospital in Pangnirtung, which is staffed
by three very able nurses, by several
nursing stations, and by lay dispensers
in small outposts.
The infant death rate per 1000 live
births is 6
times that for the rest of
Canada, and the death rate for children
one to four years of age is 15 times
that for the rest of Canada. 3
Death Rates for Infants Under I Year
of Age - Per 100,000 Live Births. 4
NWT P.Q. Canada
Lower Respiratory
Tract Infection 5458 473 434
Gastroenteritis 1463 153 120
--'-
The death rate of female children
is significantly greater than that for
males.
Three out of five children are born
at home, delivered by women who have
learned the art from their ancestors.
Pre-and postnatal care, as we know it,
is difficult to provide for such a far-
flung population.
Simple diseases have serious effects
Among the greatest causes of death
in infants under one year of age are
lower respiratory tract infections and
gastroenteritis, each 12
and 12 times
as common as in the rest of Canada. II
These figures all look very dramatic,
but it must be remembered that they
have to be interpreted with care, due
to the small number of the population.
The Eskimos living on the trading
post no longer have easy access to
their native diet, and cannot afford nor
know how to choose a balanced diet
MARCH 1967
from the variety of foods available in
the white man's stores. All too often
potato chips and soft drinks form a dis-
proportionate amount of their pur-
chase. As a result malnutrition is mani-
fested by the appearance of vitamin D
deficiency, rickets, and iron deficiency
anemia. These diseases are not seen in
the more remote camps where raw
meat is the staple diet-
Impetigo, upper respiratory tract in-
fections, and draining ears are common-
place. Our experience suggests that in
the Eastern Arctic there is a relation-
ship between middle ear disease and
social conditions. as was demonstrated
by Cambon et al 6 in the Western
Arctic.
Several epidemics of viral disease
have been recorded. 7 They have been
more severe in remote areas than in
more concentrated populations where
immunological resistance is higher.
With this in mind, a widespread pro-
gram of measles vaccination has re-
cently been undertaken by the Northern
Health Service.
Memophilus influenza and meningo-
coccal meningitis have been reported
to occur more frequently than in the
rest of Canada. In Frobisher Bay we
have seen five to seven cases per month
whereas the average from a much larger
population at The Montreal Children's
Hospital is 4.4 cases per month. Poor
housing. inadequate nutrition in settle-
ments, and resulting decreased resistan-
ce are likely contributory causes.
Chronic disease is common
The increasing influx of transient
laborers has been associated with a
rising incidence of venereal disease in
adolescents.
Routine chest roentgenograms of
Eskimo children referred to The Mon-
treal Children's Hospital for various
reasons have frequently demonstrated
a diffuse chronic non-tuberculous lung
disease. Clinically, the child mayor may
not cough, and sometimes no adventi-
tious sounds are heard on auscultation.
The significance of these findings is
not known, nor is the cause or course.
Tuberculosis has been a problem in
the Eskimo population only since the
MARCH 1967
second half of the 1800's, when con-
tact with whalers, trappers, and traders
became established. As late as 1955-57
Schaefer 8 estimated that 5- 1 0 percent
of all Eskimos reached by the Eastern
Arctic Patrol had to be evacuated for
treatment of active tuberculosis. A vi-
gorous program of BCG vaccination.
case finding, and treatment is reducing
this problem.
A. new frontier
The government departments dealing
with Canada's northland have made
great strides in recent years in improv-
ing living and health standards of the
Eskimo, and in providing education
and training. However, much remains
to be done. In the same spirit in which
other Canadian university centers have
initiated medical services in the North, *
so The Montreal Children's Hospital is
sending its residents to Frobisher Bay.
Here they are responsible for those
children requiring special medical care,
and as a result are often able to reduce
evacuations for treatment.
The residents run two well-baby
clinics a week, and work in the out-
patients department every afternoon.
An important aspect of their work is
the provision of follow-up care to those
children who have returned from The
Montreal Children's Hospital after
having been treated there. Thus, com-
munication between the two hospitals
has improved greatly. We hope that by
complementing the work of the North-
ern Health Service, their presence will
improve the medical care of Eskimo
children.
The project has already proven its
worth as a training experience by de-
monstrating how much can be achieved
far away from a sophisticated medical
center. Residents are more intimately
involved with the family and the child's
home. Much interest in the medical
problems of the Arctic is already being
*Queen's University, Kingston, Ont., sends
interns to Moose Factory in Northern On-
tario, and the University of Alberta pro-
vides intern service for the Inuvik area at
the mouth of the Mackenzie River in the
Northwest Territories.
stimulated as a result of this contact.
In summary, we "Southerners" have
been responsible for disturbing the
ecology of the Arctic. We have tempted
the Eskimo with our way of life, and
made him dependent on our technolo-
gy. As these programs of medical
service mature, we hope they will help
to restore the new generation to better
health. This done, the Eskimo will be
able to benefit from the training and
education that can equip him to parti-
cipate in our civilization.
References
l. The Northwest Territories Today. A re-
ference paper for the Advisory commis-
sion on the Development of Govern-
ment in the Northwest Territories. Ot-
tawa, Queen's Printer, 1965, p. 18.
2. Ibid., p. 123.
3. Ibid., p. 19.
4. Dominion Bureau of Statistics. Vital
Statistics 84-202 (1960) Ottawa, Queen's
Printer, 1962.
5. Ibid.
6. Cambon, K., Galbraith, J.D., and Kong,
G. Middle Ear Disease in Indians of
the Mount Currie Reservation, British
Columbia. CMAJ, 93: 1301, 1965.
7. Schaeffer, Otto, Medical Observations
and Problems in the Canadian Arctic.
CMAJ. 81: 248, 1959.
8. Ibid. 0
THE CANADIAN NURSE 31
Nursing in
the North
Nuning on Conodo's modern-doy
frontier offen 0 wide voriety
of experience ond numerous
opportunities. Nunes ore essentiol
in bringing 0 heolth program
to the vast northern area of
Canada where geography is the
single greatest enemy of health.
32 THE CANADIAN NURSE
Health care to the more than 200,000
residents scattered over 3,500,000 square
miles of territory is provided by the
Medical Services Branch of the Department
of National Health and Welfare.
Over 800 nurses, working in hospitals or
from nursing stations and health centers
located in trading posts and settlements,
meet the challenge of providing
comprehensive, community-type health
programs - even such programs
as managing your first two-wheeler.
,
,
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The northern nurse's responsibilities include
communicable disease control;
immunization programs; health supervision
and teaching through home visits,
child-health, pre- and postnatal clinics;
and health consultant in home,
school and community.
This 28-bed hospital at Frobisher Bay
is one of 16 hospitals maintained
by the Medical Services Branch.
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MARCH 1967
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The hospitals conform to federal standards
and are built in accord with the north's
special needs. They are well-equipped and
are far from primitive.
Outpost nursing stations, 42 of them, ure
located in isolated areas that hal'e no
resident physician. Two nurses, one well-
qualified in obstetrical nursing, and one
with public health preparation, staff
these centers for emergency care and
n'acuation of the seriously ill.
':!'
Visiting nurses work mainly from health
clinics in semi-isolated centers. The nurse
in the north tral'els by any means al'ailable:
plane, canoe, dog-team, fishing boat,
and, where there are roads, car.
School health IS one aspect of the total
community program. The nurse and teacher
work together to strengthen home and
school health.
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Winter working dress for the public health
nurses includes a nath'e parka and ski
outfit. A new uniform is being made up
and will include a dress suit, topcoat,
slack outfit, and ski suit. D
MARCH 1967
THE CANADIAN NURSE 33
During the last half-dozen years, the
School of Nursing and the Medical
School at Dalhousie University have
become aware that nurses serving in
the remote, sparsely populated areas
of Canada's Northland are required to
provide ca:e far beyond the horizons
defined by nursing education in Cana-
da. Dr. Robert C. Dickson, Professor
of Medicine at Dalhousie University
Medical School, and others have had
opportunity for travel and observation
in the Canadian North, and a liaison
has developed between the University
and one organization providing north-
ern health services.
Everywhere in the North the provi-
sion of health services tends to follow
one general pattern. Regional hospitals,
preferably with several doctors, are
surrounded by satellite nursing stations
staffed by one or more nurses. Trans-
portation, usually by air, is provided
from the satellite nursing station to the
regional hospital when weather condi-
tions permit, and some sort of radio
communication is maintained between
them.
The nursing stations vary in size and
facilities offered, but they serve as a
center for the health program through-
out the surrounding district, providing
outpatient clinics at the nursing station,
a few beds for inpatients, and a public
health program. A midwifery service is
provided, and there are beds and
bassinets in the station for obstetrical
patients. Initial care for seriously ill
patients awaiting transport to the re-
34 THE CANADIAN NURSE
Outpost nursing
A new program at Dalhousie University helps prepare nurses for positions in
remote areas of the North.
Ruth E. May, B.A., R.N., CM.
gional hospital is given in the station, if
possible under the radio direction of a
doctor at the nearest hospital.
A lack of doctors
It is obvious that a nurse at a
northern nursing station will be pro-
viding services which fall within the
prerogative of a doctor in other parts
of Canada. Although a doctor may
visit from time to time and be available
for some radio consultation, many of
the nurse's day-by-day activities will
require judgment and skill beyond the
scope of what we normally consider
to be nursing.
It is impossible to provide doctors
now at this level; there are simply not
enough available. Moreover, a familiar-
Miss May is the newly appointed Lecturer
in Outpost Nursing at the Dalhousie Uni-
versity School of Nursing. She holds a B.A.
degree from Wellesley College, Wellesley.
Mass., and is a graduate of the Massachu-
setts General Hospital School of Nursing
in Boston. She received her midwifery
preparation at the Frontier Nursing Service
Graduate School of Midwifery in Kentucky,
and has served for a number of years with
the International Grenfell Association in
northern Newfoundland and Labrador. For
the past eight years she has been nurse-
in-charge of the nursing station and sur-
rounding district at Mary's Harbour, Labra-
dor, an area in which about 1500 Labra-
dor fishermen live. Miss May has also been
a member of Nurses' Christian Fellowship.
ity with this type of service leads one
to feel that doctors should not be used
at this grass roots level even if they
were available. The total population
served by one of these stations is small
and often widely scattered. There is
little to attract a doctor professionally.
Diagnostic facilities are of necessity
very limited in a station of this size.
Any surgery requiring general anesthe-
sia, no matter how minor, is usually
not possible as there is normally no one
qualified to give anesthesia safely. A
very large number of the doctor's pa-
tients would need to be referred to the
regional hospital, often not because the
doctor lacked the medical background
to care for them, but because the re-
quisite facilities would be lacking.
[s it reasonable, one asks, for a per-
son educated amid all the intricacies of
latter twentieth century medicine to
work where it is impossible for him to
use a considerable portion of the know-
ledge he has acquired and where
further professional growth is neal1Y
impossible? How much better for him
to serve as a member of a medical
team at a regional hospital and for
specially prepared nurses to continue
to serve at the nursing station level.
As a familiarity with northern facil-
ities developed, one fact became in-
escapable. A large number of the
nurses serving in northern nursing sta-
tions are either foreign born or foreign
educated. This pattern developed es-
sentially because it was desirable for
these nurses to have formal preparation
MARCH 1967
in midwifery, and such preparation is
difficult to obtain on this side of the
Atlantic. Gradually a conviction arose
that facilities should be provided in
Canada to help Canadian girls wishing
to work in remote areas of the North.
We hear much these days about the
responsibility of the highly developed
nations to the developing areas of the
world and the personal rewards of this
"Peace Corps" type of service. Why
not a plan to prepare Canadian nurses
for service in the isolated areas of the
Canadian North, a plan which would
include preparation not only in mid-
wifery but in all the areas where the
nurse is required to function beyond
the scope of nursing elsewhere in
Canada.
A new program is born
Thus the Outpost Nursing Program
at Dalhousie was born. The entire fac-
ulty of the School of Nursing and
key persons at the University Medical
I School have been most enthusiastic. A
program extending over two calendar
years has been planned and will be di-
rected by a member of the University
School of Nursing faculty who is a
qualified midwife with an extensive
background of northern service at the
nursing station level.
The first class, to be admitted in
September, 1967, will be limited to
eight students, as the clinical experience
will be highly individualized with in-
tensive tutorial type teaching maintain-
ed in all areas. Applicants must be
graduate nurses and are asked to have
completed at least one year of pro-
fessional nursing experience. Prepara-
tion in public health nursing, a vital
area in northern service, will be inte-
grated throughout the program, and a
university diploma in public health
nursing as well as a diploma in outpost
nursing will be awarded at the comple-
tion of the program. Within the next
year or two a shortened course for
students who already have preparation
in public health nursing will be devised.
Students will spend their first year
in Halifax. Lectures and seminars in
basic public health nursing will be
provided during this year and also
clinical teaching within the areas of
general medicine, surgery, pediatrics,
and midwifery. Some lectures in ma-
teria medica and some basic laboratory
experience will be included. Three
teaching hospitals in Halifax have of-
fered clinical resources most enthu-
siastically for the students, and
clinical teaching and experience will
be carried out there, primarily at
the bedside, under the direction of
medical school personnel working in
cooperation with the lecturer in outpost
nursing. Opportunity will be given for
MARCH 1967
the student to develop some skill in
basic physical examination and also in
various specific procedures such as the
starting of intravenous infusions, su-
turing, and the opening of superficial
abscesses.
The second year will consist of an
internship under the direction of the
University in a northern setting, using
selected hospitals and nursing stations
of the International Grenfell Associa-
tion and the Department of National
Health and Welfare. The students will
spend half of this year exclusively
within the area of midwifery at St.
Anthony Hospital, St. Anthony, New-
foundland. The remainder of the year
will provide further teaching and su-
pervised experience in public health
nursing and in clinical medicine, sur-
gery, and pediatrics. Opportunity will
also be given for the students to de-
velop some skill in routine dental
extractions.
Midwifery emphasized
Particular care has been given to the
development of the midwifery section
of the program. A comprehensive nine-
month experience has been arranged
with three months during the first year
in Halifax and the remainder during
the internship year. Lectures will be
given by the lecturer in outpost nursing
and the obstetrical staffs of the hospi-
tals involved.
Each student will have the opportu-
nity to care for in labor, and to deliver,
approximately 30 to 40 women. Op-
portunity to evaluate, follow, and con-
tribute to the care of patients with
abnormal courses will be provided.
There will be extensive experience in
antenatal clinics with emphasis on
patient and family teaching. During the
internship, when travel permits, there
will be a program of weekly home
visits to mothers and babies following
discharge from hospital.
Experience in postpartum care and
management of the normal newborn
and premature infant will be provided.
As in all the clinical areas, teaching
and supervision will be individualized
on a tutorial pattern.
This experience will use as a found-
ation the three months in obstetrical
nursing that students receive in their
basic nursing education program. Al-
though basic obstetrical nursing is not
midwifery, it does serve as a very useful
background, and some lectures review-
ing and expanding this material will be
given before the students embark on
their full-time midwifery experience.
At the end of the program, there-
fore, the students will have completed
a total of one year within the overall
area, three months during the basic
nursing course, and nine months during
the outpost nursing program. This has
been arranged to be equivalent not
only in time but also in content with
the British pattern of midwifery pre-
paration, and the University feels that
graduates of the program can be ex-
pected to function at the same level of
competence. It is hoped that the esta-
blishment of this experience will re-
present a significant achievement in the
history of nursing education in Canada.
Constant emphasis throughout the
entire program will be given to the
early recognition and evalution of sig-
nificant illness and potential threats
to the well-being of the patient and his
family. The nurse must learn to initiate
treatment or transfer the patient to a
hospital before an emergency situation
develops; one of her aims must be to
prevent the development of emergency
situations in isolated nursing stations
whenever this is possible. However,
there will be discussions of reasonable
plans of action in unavoidable or un-
predicted emergencies when medical
aid or transport to hospital is not im-
mediately available.
Considerable thought has been given
to the identification of those functions
and procedures that can be taught
safely to nurses and to those that she
should avoid. h is essential that the
students be taught to recognize and
respect their limitations. It should be
noted, also, that it is never intended
for these students to use the specific
skills developed within this program in
other areas of Canada where such care
is provided by resident doctors.
Arduous, but rewarding
The type of northern service for
which this program in outpost nursing
seeks to prepare nurses is arduous, and
nurses considering service of this sort
should face the demands realistically.
There are likely to be emergency
situations and tragedies that must
sometimes be met and accepted alone.
Many of the common amenities of
twentieth century living will be lacking.
There can be periods of drudgery and
loneliness; in due time the glamor is
likely to fade. However, those who
have steeped themselves in this work
have found the rewards far outweighing
the demands. There will always be a
tremendous challenge and satisfaction
in attempting to provide the best
possible service to those whose birth-
right has included so much less than
ours.
Hundreds of years ago Jesus said to
a group of his friends,
"In so far as you rendered such
services to one of the humblest of
these my brethren, you rendered
them to myself." - Matthew 25:
40, (Weymouth). D
THE CANADIAN NURSE 35
Drug dependency research -
expensive luxury or necessary
commodity?
Mood-changing drugs and their
effects on those who ingest them have
received much attention during the
past few years. Drugs hold a special
fascination - they at once attract and
repel. Purveyors of juicy newspaper
headlines, spicy television programs,
lurid tales, are guaranteed a market.
However, whatever sensational quali-
ties drugs may have, only serious study
will enhance our knowledge to the
point where fact rather than fancy will
prevail.
Research, for the most part, is not
sensational. Unless some spectacular
scientific breakthrough is achieved, it
does not merit newspaper headlines.
It is often forgotten that behind each
striking discovery are years and years
of quiet and often frustrating research
and experimentation. Serendipity is
indeed rare!
Fortunately, more and more quali-
fied researchers are now studying
mood-changing drugs and their physio-
logical, pharmacological, psychological
and sociological effects. To be sure,
one meets the very people who are part
of interesting tales told, but the collec-
tion of factual data is an expensive,
time-consuming and, at times, very
tedious process. Nor are research re-
ports recommended bedtime reading
unless perhaps for quick sleep induce-
ment. For research into drug depen-
dency must embrace such mundane
matters as prevention, pharmacology,
epidemiology, treatment, and legisla-
tion. and must assure a systematic ac-
36 THE CANADIAN NURSE
In drug dependency research, the questions are still more
plentiful than the answers.
Ingeborg Paulus
cumulation of general knowledge. It
therefore has to draw on various dis-
ciplines to make it less of a riddle to
those engaged in preventing and fight-
ing a disease that seems to take on new
shapes as more and more mood-
changing drugs become known and
available for experimentation.
NAF research program
The Narcotic Addiction Foundation
of British Columbia (NAF) was found-
ed in September, 1955, with the objec-
tive "to develop a research, treatment,
rehabilitation and education program."
Many obstacles prevented the develop-
ment of all goals simultaneously. Con-
sequently it was not possible until the
end of 1964 to start the development
of a research program.
Research should include a thorough
examination of the many-faceted as-
pects of drug dependency and abuse.
Lack of financial resources have, to
date, prevented the NAF from doing
other than rudimentary medical and
sociological research. We have been
engaged in sociological research for
two years. Some projects are finished,
some are in progress, and some are in
the planning stages. The following is
a short account of research undertaken
by the NAF.
Miss Paulus is Research Associate with
the Narcotic Addiction Foundation of British
Columbia. Vancouver. B. C.
Past endeavors
Information Collection on the NAF
PatienJ Population
Any research calls for the accumu-
lation of a body of data that lends
itself to manipulation. That is, if data
are to be meaningfully interpreted they
must be complete rather than frag-
mentary; they must be ordered into
some meaningful categories rather than
be a haphazard mess; and they must
be accurate. The collection of this kind
of data is not always easy. It is further
complicated when the respondent is
a patient who quite often comes for
help only when he is drugged, agitated,
or in the process of withdrawal; in
other words, when his reasoning and
memory frequently are impaired.
This, then, was a first task: to
devise a suitable form for collecting
necessary information during the intake
process, which would provide up-to-
date knowledge of our patient popula-
tion. Data on socioeconomic character-
istics such as age, sex, marital status,
education, etc., are now easily checked.
We can get immediate information on
our patients' origin, period of addic-
tion and criminal record, accumulated
either prior or subsequent to addiction.
Apart from knowing something about
the NAF treatment population, this
kind of information is used to devise
prevention and treatment methods.
Treatment Results
One of the primary functions of the
staff at the NAF is to treat and reha-
MARCH 1967
bilitate its patients. How do we know
whether or not our methods actually
produce the desired results? One way
is to compare two similar groups -
one following a specific treatment
program, the other not. After a suitable
time lapse, the two groups can be
followed up and the effects of treat-
ment measured and assessed. The re-
sults of such a study may be inconclu-
sive, yet they may give clues to success-
ful treatment approaches. Unfortun-
ately, this type of prospective treatment
assessment study is time-consuming. It
may be five or six years before suffi-
cient data are available for drawing
conclusions that can be generalized
over a larger population. Moreover,
ethical considerations may prevent this
type of research. Is one justified to
treat some patients and not others?
What criteria for selection should one
employ? These are very serious ques-
tions that the treatment team must
answer before such a study can be
started.
Retrospective follow-up studies are,
at best, compromises. One has a group
of patients treated some years ago; to
find out what has happenned to these
patients since their treatment is diffi-
cult, since the necessary controls are
lacking. If a considerable number of
patients had improved, one would not
be justified in attributing this to the
treatment, for other factors, including
time, may have been equally important
in bringing about a change.
At the NAF we were faced with a
unique situation. In 1963, Dr. R. Halli-
day, past clinical director, decided to
change the drug addiction treatment
radically from that usually practiced in
North America, by maintaining selected
patients on small doses of metha-
done for anywhere from 4 to 52 +
week periods. At the same time the
NAF continued treating a portion of
its patients by giving them regular,
12-day withdrawals, in conjunction
with the standard social work, psy-
chiatric, and medical treatment given
to all patients.
We could compare the two treatment
populations and assess results, but we
could not assess the effectiveness of
either type of treatment. Since one
treatment was quite different from any
practiced during the past 40 years, we
decided to do a retrospective follow-up
study. As expected, the results of the
study were inconclusive, but they did
give an impetus to planning a long-
range prospective study. Without the
retrospective study, we might not have
learned anything. By doing it, we
gained at least enough knowledge to
guide us in the future.
Briefly, the study suggested that
older patients responded more favor-
MARCH 1967
ably to either type of treatment. Age
seemed to be the most important vari-
able, influencing change in a positive
direction. For patients over 50 years
of age, in particular, the prolonged
methadone treatment program indi-
cated promising results..
From what we were able to learn,
we concluded that the NAF is serving
the community by maintaining all pa-
tients over 50 years on a narcotic
drug. It seems that various processes
(to be investigated shortly) take place
in addicts' lives that can best be de-
scribed as "maturing-out of narcotic
addiction" (a term coined by Dr. Char-
les Winick, director, program in drug
dependence and abuse of the American
Social Health Association). But these
processes seem to fail for a consider-
able portion of the addict population.
This portion seems to be unable to
function without some chemical help.
To offset the detrimental aspects of
the illegal procurement of drugs, a
maintenance-treatment program seems
an economical choice. As yet, we do
not know what kind of treatment is
indicated for younger addict patients.
We feel that only new experimental
approaches will help us further.
Present research
Barbiturates
During the past few years, we have
noted several changes in drug abuse
patterns. First, increasingly more
heroin addicts are using barbiturates,
either alone or in conjunction with
their heroin or methadone intake. We
noted a rapid increase in barbiturate
consumption especially among women.
We postulated various hypotheses for
this change in drug abuse patterns,
which we were testing on a sample of
our patients. The major hypothesis that
the supplementation of heroin with
barbiturates is mainly an economic
necessity was confirmed. Furthermore,
the easy availability of barbiturates also
contributes to their heavy abuse.
We know that the abuse of barbitur-
ates and amphetamines is not limited
to heroin addicts. Unfortunately, our
resources do not allow us to undertake
an investigation into these drug abuses.
A strong necessity for research into this
problem exists, but it is fraught with
difficulties. The result is that very few
accounts other than "popular press"
articles are available to bring this
serious abuse, with its detrimental phy-
sical and social consequences, to the
l
.--
,.
I
. Ingeborg Paulus, "A comparative Study
of Long-term and Short-term Withdrawal of
Narcotic Addicts Voluntarily Seeking Com-
prehensive Treatment," Vancouver, B. C..
The Narcotic Addiction Foundation of
British Columbia, April, 1966.
THE CANADIAN NURSE 37
"
..
,
\
\
\
attention of an uninformed public.
Psychetklics
At the present time, there seems to
be an insatiable demand for accounts of
the dangers and delights associated
with the marijuana (cannabis sativa)
and LSD-25 (lysergic acid diethylamide)
cult. As expected, the popular press
has taken the lead in "informing" the
public about this cult. Speculations and
half-truths fill page after page. Factual
research is time-consuming, and before
responsible findings are released, the
myths surrounding these drugs seem to
overshadow the realities. It becomes
increasingly difficult, even for the wary
researcher, to separate fact from fancy.
The NAF study is especially interest-
ed in distinguishing between the drug
abuser and the isolated young ex-
perimenter. It seems to be part of the
follies, and perhaps the privileges of
youth, to taste some of the forbidden
fruits of life. Thus we are trying to
determine who the young people are
who are so attracted to psychedelic
drugs that they risk incarceration and
a criminal record just to partake of
these forbidden "pleasures."
We must ask such questions as: Will,
in a few years from now, our clinic be
overrun with narcotic drug users who
started on their road to addiction via
the psychedelics? Or will the use of
psychedelics be a fad with no direct
consequences as far as our future treat-
ment population is concerned? Will
this group of drug abusers need treat-
ment at all? Or will it need treatment,
but different from that required by the
heroin addict? In other words, we are
trying to find present facts on which
to base future actions and policies.
Planned research
From our past endeavors we are
perhaps able to answer some questions;
but our questions are still more plenti-
ful than our answers.
Prospective Treatment Follow-up
Study
One issue to be investigated, which
arose out of the retrospective follow-
up study, is the effectiveness of the
38 THE CANADIAN NURSE
present treatment the NAF is able to
give. The retrospective follow-up study
could not answer this question, because
we had no untreated population as a
control. It did, however, enable us to
formulate a treatment-research pro-
gram. The proposed study will be very
expensive; therefore, its realization is
dependent on financial support present-
ly being sought.
Natural History of Addiction
A less expensive but no less impor-
tant project involves the investigation
of the natural history of addiction. By
questioning the addict and from ac-
cumulated records, we want to dis--
cover: who the addict was before he
started to use drugs; the deciding fac-
tors that made him experiment with
any kind of drug; the unpleasant re-
alities he was trying to escape; what
happened once he started to use drugs;
the length of the drug-use span; and
what made him stop using drugs. In
other words, what does an addict
career entail? Does it come to a natural
or unnatural end? And, once ended,
what then?
Goal: Prevention of abuse
When we have answered some of
these questions, we might be able to
launch a more effective campaign of
drug abuse prevention. This, we feel,
merits our greatest efforts. Although it
is essential to know how best to treat
addicts. it is much more essential and
also less expensive to prevent drug ex-
perimentation and abuse. The com-
petition for tax-payers' dollars to
prevent and cure society's various ills
is heavy. The more we learn how to
prevent these ills, the more funds will
be available to enrich all of our lives.
It may seem that in view of the pres-
sing demands for treatment, research is
an expensive luxury; but viewed in the
light of its long-term benefits, research
is one of the most necessary commodi-
ties when dealing with the riddle of
drug dependency and abuse. D
MARCH 1967
For some years there has been con-
siderable controversy as to the validity
- or even morality - of using nar-
cotic drugs in the treatment and reha-
bilitation of narcotic drug addicts. To
many people the concept that addicts
can be treated or cured appears naïve,
or even ludicrous; follow-up statistics
from various treatment centers are
quoted to indicate that the vast major-
ity of addicts following treatment, in
or out of prison, quickly relapse to
their former way of life, that is, to
criminal behavior or prostitution, as
well as to the use of narcotic and other
addicting drugs.
On the other hand, there are those
who commend what they term the
"British system" of treating addicts.
They conclude that the relatively small
number of addicts in Britain (about
753 according to the British Ministry
of Health report, 1965)1 is due to this
supposed method of treating addicts
there. When compared with Canada's
known addict population of 3,573 in
1965,2 (in a population of 20 million
as compared with Britain's population
of more than 50 million) it may seem
that there is something about the legal
and medical management of addicts in
Britain that we in Canada might study
and adopt to our advantage.
No "system" in Britain
When one takes a closer look at the
situation in Britain, a number of facts
become apparent. First, there is in
reality no "system" of treating addicts
MARCH 1967
Use of narcotics
addict therapy
.
In
Treatment of persons addicted to narcotics is frequently a dismal failure. The
question of the role of narcotic drugs in the treatment of such persons
still remains unanswered.
Robert Halliday, M.B., D.P.M.
in Britain if, by system, one means:
that all addicts are given narcotics
regularly in the course of treatment;
that the government has clinics to
which addicts may go for treatment;
or that all drug addicts are registered
and, once registered, are automatically
placed on a narcotic for an indefinite
period, or even for life.
Further, when one considers the law
relating to the manufacture, sale, dis-
tribution, and use of narcotics or dan-
gerous drugs, it becomes apparent that
British law is very similar to Canadian
law.
From whence, then, comes the myth
of the "British system"? - for myth it
is. In fact, there is no system of regis-
tration; nor are there government
clinics; nor is it government policy (via
the ministry of health or elsewhere) to
encourage or direct physicians to treat
addicts with narcotics. Indeed, in the
British Ministry of Health report re-
ferred to earlier, the following recom-
mendations, among others, are made:
that all addicts to dangerous drugs be
reported to a central authority; that to
treat addicts a number of special treat-
ment centers should be established, es-
pecially in the London area; and that
it should be a statutory offence for doc-
tors (other than those on the staff of
the special treatment centers) to pres-
cribe heroin and cocaine to an addict.
Dr. Halliday is Co-ordinator of Education
for the Narcotic Addiction Foundation of
British Columbia, Vancouver. B.C.
These recommendations make it quite
clear that the "British system," so
lauded by many naïve, if well-meaning
people, is not a reality.
Addiction considered an illness
What does happen in Britain that is
different from typical Canadian policy
and practice? As far back as 1924, the
Rolleston Committee, which investi-
gated the problem of narcotic drug
abuse for the British Government, con-
cluded that morphine or heroin might
properly be administered to addicts in
the following circumstances:
1. Where patients are under treat-
ment by the gradual withdrawal
method with a view to cure.
2. Where it has been demonstrated
after a prolonged attempt at cure that
the use of the drug cannot be safely
discontinued entirely, on account of
the severity of the withdrawal symp-
toms produced.
3. Where it has been clearly de-
monstrated that the patient, while
capable of leading a useful and rela-
tively normal life when a certain mini-
mum dose is regularly administered,
becomes incapable of this when the
drug is entirely discontinued.
A memorandum from the British
Ministry of Health to physicians in-
cluded this statement: "The continued
supply of drugs to a patient, either
direct or by prescription, solely for
the gratification of addiction, is not
regarded as a medical need."3
It may be concluded that one sign if-
THE CANADIAN NURSE 39
icant difference between the British
and Canadian attitudes toward addicts
is that in Britain addicts have been
recognized as people in need of medical
help, whereas in Canada and the U.S.,
until recently, the addict has been re-
garded as a criminal, and treated as
such.
It was only in 1961 that Canadian
legislation regarding illegal possession
of narcotics was altered, and the man-
datory six months minimum jail sen-
tence of convicted persons revoked.
This jail sentence was never mandatory
in Britain. Usually fines, suspended
sentences, or probation were employed,
rather than imprisonment.
Athough certain addicts - notably
the so-called criminal addicts - are
normally reluctant to enter hospital for
treatment, the fact is that in Canada it
is almost impossible to obtain a hos-
pital bed (general or psychiatric) for
such therapy. In Britain it has usually
been easier for the addict to gain ad-
mission to and obtain treatment in a
hospital. Again, the emphasis has been
on the addict as a sick and dependent
person, whatever his criminal activities
may be.
In Canada today
The first recommendation of the
Rolleston Committee (now 40 years
old) is generally accepted in Canada
today. In most instances the synthetic
narcotic methadone hydrochloride is
used in the withdrawal program. It has
been demonstrated that over a period
of from one to three weeks, most nar-
cotic addicts (heroin being their drug
of choice) can be safely withdrawn by
gradually reducing the methadone
which is substituted for the heroin.
Since heroin cannot be legally ob-
tained for any purpose in Canada, it
cannot be used, though morphine or
other narcotics may be used as the
substitute. However, methadone has be-
come most widely accepted, and, be-
ginning with an initial dose of about
40 mg. daily, can be safely and gradu-
ally reduced until no narcotics are
being employed. Other drugs - tran-
quilizers and antidepressants - may
also be used in conjunction with the
methadone, and continued as necessary
after the latter has been discontinued. 4
But what about the second and third
40 THE CANADIAN NURSE
recommendations of the Rolleston
Committee? How are they to be in-
terpreted? With our present knowledge
of the treatment of addicts, both of
these recommendations are more sub-
ject to criticism than when they were
originally advocated. However, it is still
true that treatment is frequently a dis-
mal failure, in spite of our opportun-
ities, and the question of the role of
narcotic drugs in the therapeutic regi-
men still remains.
NAF experiment
The Narcotic Addiction Foundation
of British Columbia is a private agency
engaged in the treatment of the addict
patient at liberty in the community who
seeks treatment voluntarily. [n 1963
the NAF decided to apply the Rolles-
ton recommendations in the treatment
of certain selected, and usually older,
patients whose history indicated re-
peated failure in therapy. It should be
noted that drug therapy, though fre-
quently an essential part of the treat-
ment and rehabilitative program, is not
the only, or indeed the main aspect.
The rationale for the procedures
used depends on the recognition of the
addict as physically, psychologically,
and socially sick. He is a disturbed
and dependent person, who has gradu-
ally focused his life around those pro-
cesses by which he obtains the drug,
and the gratification he receives from
it. Further, in most addicts of this
group the dependency and seU-des-
tructive needs are so great that to begin
their therapy without the use of narcot-
ics (if they are at liberty and not in
control) would be unthinkable. In other
words, their motivation is poor, and
their ability to get along without drugs
in a reasonable way is minimal.
We hoped that by administering
methadone for a longer period, while
at the same time continuing investiga-
tion into the physical, social and psy-
chological problems of the individual,
and using suitable therapies (medical,
psychiatric, counseling, re-education,
job-training, and job-finding, etc.), we
would be able to help the individual
to become less dependent on the nar-
cotic, to reduce or resolve his social
and emotional conflicts, and gradually
assume m9re responsibility for him-
seU. In such a program, the drug -
comparable in some ways to the pro-
longed use of tranquilizers or antide-
pressants in treating mentally ill pa-
tients in the community - would be
an essential feature of therapy, and
would assist many addicts to lead more
Ilseful and constructive lives. Our ex-
perience with this method at the NAF
has tended to confirm the above hypo-
thesis, and many "hard-core" addicts
have given up their criminal and anti-
social behavior under this regimen. 5
More recently, Dole and Nyswander6
in New York have experimented with a
variation of this approach, and while
results are still tentative, they again in-
dicate that for some addicts such an
approach is worthwhile, is less costly
to the community, and at worst helps
to prevent many addicts from contin-
uing and repeating their cycle of
drugs, criminality, jail, and more drugs.
Changing attitude
Since the aforementioned British
recommendations were proposed, our
understanding and approach to the
treatment of the addict has gradually
moved toward acceptance of him as a
sick person who needs treatment, what-
ever other forms of control might be
desirable. This principle is operative
even when imprisonment is assigned
for criminal acts. Within this past year
a new federal drug treatment center for
convicted offenders has been opened at
Matsqui, in the Fraser Valley, British
Columbia. After screening, selected ad-
dict offenders are sent to this center
for treatment and rehabilitative mea-
sures, which will extend into after-care
support, with extensive use of parole.
These measures are the result of a
changing and more enlightened social
attitude about the causes and manage-
ment of addiction - an attitude es-
sential to more sophisticated social
action.
Although this approach to treat-
ment is helpful to some addicts, it is
by no means helpful to all. Many
drug-dependent individuals require ex-
ternal controls in a clinic or hospital
setting for some time before they have
reached the degree of maturity, under-
standing, and social progress, which
will enable them to exercise control
over themselves while at liberty in the
community. In New York and Califor-
MARCH 1967
.
t
MARCH 1967
......
.
I
...
,
nia, legislation has been enacted that
petmits "committal" of suitable addicts
to such a treatment setting; similar
legislation is desirable in Canada.
Conclusion
The reader is referred to the recom-
mendations of the Special Committee
of the Canadian Medical Association, 7
which spells out the components of
good medical care in the treatment of
the addict. These include the following
advice: "It may, in certain circumstan-
ces, be good medical practice to pre-
scribe maintenance doses of narcotics
for long periods to an addict at liberty,
if other components of good medical
care are also provided. If they are not,
the doctor may be guilty of trafficking.
Our advice to general practitioners is
that they should, if possible, avoid
prescribing narcotics for long periods
for addicts under their care."
References
I. Great Britain. Interdepartmental Com-
mittee on Drug Addiction. Drug ad-
diction; the second report. London, Her
Majesty's Stat. Office, 1965.
2. Division of Narcotic Control. Ottawa,
Department of National Health & Wel-
fare, 1965.
3. Special Committee on the Traffic in Nar-
cotic Drugs in Canada. Proceedings, 2nd
session, 22nd Parliament 3-4 Elizabeth
II. 1953- I 954. Ottawa. Queen's Printer,
1955.
4. Halliday, R. Treatment of the narcotic
addict. H.C. Med. Joumal, 6: 421, 1964.
5. Halliday, R. Narcotic drug addicts as
voluntary patients; the use of metha-
done on short-term and long-term with-
drawal treatment programs. Report to
Committee on Problems of Drug De-
pendence. National Academy of Sciences,
Washington. D.C., 1966, p. 4599 (Un-
published)
6. Dole V.P. and Nyswander, M. Medical
treatment for diacetylmorphine (heroin)
addiction; a clinical trial with methadone
hydrochloride. J. Amer. Med. Assoc.
193: 646, Aug. 23, 1965.
7. Good medical practice in the care of the
narcotic addict. A report prepared by a
Special Committee appointed by the Exe-
cutive Committee of the Canadian Medi-
cal Association. Callad. Med. Assoc. J.
1040-1043, May 8. 1965. 0
THE CANADIAN NURSE 41
Care of patients addicted
to non-narcotic drugs
On admission to hospital, the per-
son addicted to non-narcotic drugs may
appear intoxicated; but there is a subtle
difference between him and the person
intoxicated with alcohol. The drug ad-
dict's difficulty in walking is usually
more marked than his ability to speak
or comprehend. An alcoholic who
finds it hard to maintain balance, looks
half asleep, has incoherent speech, .and
usually falls into bed and to sleep
quite quickly. The drug addict, on the
other hand, has difficulty maneuvering,
but is much more aware of what is
going on; although his speech may be
somewhat slurred, he makes sense.
Quite often the patient has a mixed
addiction - to both sedative drugs
and alcohol - which may be sus-
pected by his unusual behavior. Fre-
quently a patient who is admitted for
treatment of an alcohol problem de-
monstrates an additional problem by
begging for a certain kind of drug.
Staff are always aware of the possi-
bilitv that a patient is in the process
of changing his dependence from al-
cohol to sedatives. From the stand-
point of clinical management, depend-
ence on alcohol is the lesser of two
evils.
Alcoholics may switch drugs
Many alcoholics begin to use bar-
biturates or tranquilizers when, for
various reasons, they can no longer
take alcohol without being in trouble.
One patient who had changed his de-
pendence from alcohol to pills was
42 THE CANADIAN NURSE
Nursing a patient who is addicted to drugs is much more difficult than nursing
one addicted to alcohol. The drug addict takes longer to withdraw, wants to hang
onto his chemical beyond reason, is wretchedly uncomfortable, jittery, and
anxious for days. He tries the patience and ingenuity of the staff to the utmost.
Mary L. Epp
brought to hospital by his wife. It was
a frustrating conference. His wife was
threatening to leave him, the doctor
was stressing the dire physical and
mental consequences of his continued
use of pills, and his employer was sug-
gesting that he was in danger of losing
his job. But he sat there quite happy
through it all. He was so thoroughly
tranquilized that he was incapable of
worry and refused to stay for treat-
ment. He might have been more ame-
nable to reason the next morning after
he had "slept off" some of his sedative.
Other persons start taking drugs on
prescription, but increase dosage until
it is so out of control that they be-
come intoxicated, fall down frequent-
ly, and are quite unable to cope.
Choice of drugs
The drugs to which a person may
become addicted include anything that
can change the way he feels, such as
Aspirin, A.P.c. & C's, barbiturates,
tranquilizers, bromide, paraldehyde,
amphetamines, chloral hydrate, codei-
ne, morphine, heroin, methadone, De-
merol, or mixtures of these. When a
person is becoming dependent on a
drug he is very careful not to run out
of his special brand - although he
may take only a few pills a day. Later
in the addiction he will not be as par-
ticular about the type of drug he uses,
as long as there is plenty.
Mrs. Epp is Director of Nursing at The
Bell Clinic in Willowdale. Ontario.
Clothing and luggage searched
A good way to admit a patient who
is addicted to drugs is to take him
directly to an examining room, where
he is seen by the admitting doctor
while his luggage is left elsewhere and
very thoroughly and carefully search-
ed. His pyjamas and dressing gown
are taken to him only after all pockets
have been checked; his clothes are
removed from the room and examined
for drugs. Pills have been found in
trouser cuffs and billfolds - in fact,
almost anywhere. A woman has many
hiding places among her cosmetics.
The examination of clothing and
personal effects should be done rou-
tinely even though the patient seems
to be sober, is channing and good
looking, and assures you he has noth-
ing to hide. At the risk of feeling
foolish for insisting on this routine,
you must resist the temptation to escort
the patient directly to' his room. After
you have been fooled a few times you
will be quite matter-of-fact about the
searching performance even if you
have to do it in front of the patient.
These patients are not trustworthy
while they are undergoing withdrawal
and we can help them only when they
realize that they cannot manipulate the
staff. Actually, most patients expect to
be searched.
Some patients arrive with an as-
tonishing variety of pills scattered
among their belongings. Besides the
tranquilizers and/or barbiturates, they
often have laxatives, diuretics, antacids,
MARCH 1967
,
l
MARCH 1967
-\
"
-
pills for hypertension, etc. It is im-
portant to take every pill away. After
consulting the family physician, the
staff doctor will decide which ones,
if any, the patient requires.
Withdrawal routine
During treatment, we are careful
to avoid transferring a patient's de-
pendence to another type of pill. This
is particularly true when treating pa-
tients with a drug that demonstrates
cross-tolerance with the addicting drug.
Patients are told that they will have
to put up with some discomfort. If
they are made as comfortable on the
new pill as they were on the old, they
will never recover.
At the beginning of treatment a
drug addict finds it difficult to coop-
erate. Do not expect him to tell the
truth about his addiction. To plan the
treatment of his withdrawal reaction
it may be important to know how
much he has been taking; however,
you cannot rely on what he tells you.
This may be partly because he is
ashamed of his addiction and partly
because he quite truthfully does not
know. It is a well-known fact that
many so-called suicides are the result
of unintentional overdose. The addict
forgets how much sedative he has
taken or is too impatient to wait for
the drug to take effect.
Barbiturates
If the patient has been taking large
amounts of barbiturates for a long
THE CANADIAN NURSE 43
time, he may have a convulsion on
abrupt withdrawal in spite of treatment
with anticonvulsant drugs. Under these
circumstances the physician usually
withdraws the barbiturates gradually
and administers both tranquilizers and
anticonvulsants concurrently. If the
patient is addicted to a tranquilizer, he
is usually switched to another tran-
quilizer at once and the dosage is
gradually reduced to zero.
Paraldehyde
Paraldehyde makes an alcoholic feel
wonderful. It is a derivative of alcohol
and much stronger. To many alcoholics
who have learned to put up with the
taste and smell, this is the drug of
choice on withdrawal. The odor. of
course, is unmistakable and the nurse
can only hope that when a patient is
admitted smelling of paraldehyde, it
has been prescribed for him, and not
taken voluntarily for its "welcome"
effects. In the latter case there may
be considerable difficulty withdrawing
the patient from his drug.
Amphetamine
The withdrawal reaction of the am-
phetamine addict is in sharp contrast
to that of the addict to sedative drugs
or alcohol. He is very sleepy and dull
and complains of having difficulty in
thinking. If he is presumed to be an
amphetamine addict and does not
behave in this way, we may suspect
a mixed addiction, that he has some
concealed supplies, or that he plans a
trip to the drug store at the first op-
portunity.
Support from staff
A great deal of time is spent by
the staff in reassuring and getting ac-
quainted with patients in the first
stages of a recovery program. Persons
addicted to drugs need to learn to de-
pend on people rather than chemicals
and they start with a new dependence
on the hospital staff. When this shift
in dependence begins, the staff must
be prepared to accept it for a pro-
longed period, sometimes years. while
hopefully the patient learns to depend
on other people as well.
44 THE CANADIAN NURSE
Patients may choose a particular
member of the staff as their "mentor."
Care must be taken to maintain a
professional, although friendly, atti-
tude. A rule that patients are seen only
at the clinic or hospital and that phone
calls all take place while the nurse is
on duty is a stabilizing influence. No
staff phone numbers are released to
patients
Sitting down and chatting with the
patient will help to pass the time for
him and also give you a better idea of
just how the withdrawal is going. Pa-
tients may put on a show to get more
pills or more attention. We must try
to understand that they are probably
afraid of life without their chemical
comfort. Sometimes a patient can be
helped to appreciate his situation by
comparing his continuous drug intoxi-
cation to a big downy comforter which
he has wrapped around himself as pro-
tection from all his problems. As he
is withdrawn he becomes naked and
vulnerable and is hurt over and over
again. A scolding from his wife, loud
noises, the idea that he may have
damaged himself permanently, all hit
him with nothing to cushion the blow.
With growing awareness that the
staff is capable and really wants to
help him, the patient becomes less
apprehensive about being withdrawn
from his chemical comforts. During
the withdrawal period he desperately
needs attention and kindness, and often
finds it hard to believe that the nurse
cares what happens to him. Your con-
cern and belief that he can be better
gradually penetrates and he begins to
have some hope that life without pills
is possible - if not too acceptable
at first.
It is amazing how soon patients
want to get up and around. They will
et cleaned up as well as they can and
ioin the other patients ño matter how
they mav feel or how shaky and un-
steady thev are. Sometimes the staff
mav fear that these patients will fall
or disturb other patients; but it would
seem that the comfort they get from
being with others, even thoue:h they
may - be dozing part of the time, as-
sists the withdrawal process.
Visits after discharge encouraged
Persons who have been discharged
from hospital are encouraged to visit
the staff regularly. Most ex-patients
particularly enjoy a chat with their
favorite nurse, but anyone is better
than no one. Other members of the
staff, therefore, must be prepared to
help if someone's patient phones or
visits when she is off duty. He may
be unhappy and jittery and will need
to be encouraged to put up with the
way he feels for the time being. We
hope that he will learn, too, that talk-
ing with any understanding person can
be of help. This points up the neces-
sity for regular staff conferences, as
well as the importance of recording the
nurses' conversations about patients.
Not all recover
Unfortunately, some persons are so
emotionally disturbed and so chroni-
cally uncomfortable that they are
unable to function in society at all
without some chemical dulling of un-
pleasant reality. For such patients,
the smallest dosage which will enable
them to carry on is maintained. It
may be necessary to change the kind
of medication occasionally as their
tolerance for one kind builds up.
Conclusion
It is important for nurses to realize
that although it may take a great deal
of effort and a long time, it is pos-
sible to help most people to learn to
live without sedative drugs and to be-
come more comfortable through im-
proved communication with others. 0
MARCH 1967
I am employed as a nurse in the
Small Animal Surgery at the Ontario
Veterinary College in Guelph, Ontario.
How did I get here? Almost acci-
dentally.
In the fall of 1964, I heard by the
grapevine that the services of a nurse
were being considered for the operating
room at O.V.c. Because of my interest
in animals and the enticement of regu-
lar hours of work, I investigated. At
the time, I had been on the staff of a
Guelph hospital for 10 years since my
graduation as a registered nurse in
1949. I am married, have two teen-
age sons, and. of course. a dog and cat.
Many patients referred
In the Small Animal Department at
the Veterinary College, there is a hos-
pital and outpatient clinic for the pub-
lic. All pets of local residents are
received on appointment, examined by
a clinician on staff, and given treatment
or hospitalized as inpatients.
Many difficult cases are referred to
the clinic by out-of-town veterinarians.
Animals are sent here from all over the
country, from as far west as British
Columbia, and as far east as the Mari-
time provinces. Many, too, are natives
of the United States.
A variety of patients
Our patients include grand champi-
on show dogs, field trial dogs, and
many good old lovable mongrels. Cats,
too, are represented on our patient list.
Occasionally our feathered friends
MARCH 1967
Deserter of people?
"Few nurses have patients like mine, which include grand champion show dogs,
lovable mongrels, cats, and even a few feathered friends."
Jean Wilkinson
-...
,
--""
Mrs. Wilkinson is nurse in the Small
Animal Surgery at the Ontario Veterinary
College jp Guelph. Ontario.
require treatment. An old grey owl had
a broken wing pinned successfully; a
snow goose had a tumor removed; and
a peacock and homing pidgeon re-
quired medical care. Birds are poor
anesthetic risks, however, and rarely
become surgical patients.
Animals have many of the same
diseases as man plus some peculiar to
themselves. The following operations
are done on dogs and cats: tonsillecto-
my. splenectomy, cystotomy, lobecto-
my, diaphragmatic hernia repair, tho-
racotomy, kidney transplants, open-
heart surgery, thoracic surgery, lami-
nectomies, and all types of orthopedic
surgery. Pins and plates are used al-
most daily in some unfortunate dog
who has met an accident with a car. A
fractured femur, radius, tibia, pelvis,
etc., can be pinned or plated success-
fully and "Fido" will be up and run-
ning about on all four legs in a matter
of a few weeks.
Occasionally we have a cesarean
section. It's quite exciting when several
people are "puppy rubbing" the small
pink-nosed puppies who squeak loudly
at this indignity. After the mucous is
removed from nose and mouth, the
newborn is placed in a heated box with
several brothers and sisters - any
number, from one to nine.
Strict aseptic technique in O.R.
The surgery here is modern, air-con-
ditioned, and well-equipped. We have
three operating rooms plus a scrub
room and working area. The operating
suite could be compared to one in a
small hospital. The most stringent asep-
tic technique in operating room pro-
cedure is carried out for all animals.
Doctors scrub, gown, and glove.
Before the animal is brought in, his
operative area is shaved and the skin
cleansed with antiseptic. Dogs and cats
are anesthetized and wheeled in on
stretchers. The most common anesthe-
tic for these animals is Nembutal. given
intravenously. Sodium Pentothal and
Surital are used intravenously for mi-
THE CANADIAN NURSE 45
The operating rooms for small animal
surgery are nwdern, air-conditioned,
and well-equipped.
Strict aseptic technique is carried out
for all types of surgery.
...
-......
--"
.
\.
l
'-
--- '..
46 THE CANADIAN NURSE
nor surgery and for anything that re-
quires a short-acting anesthetic.
We have two large anesthetic ma-
chines for f1uothane inhalation, used
mainly on older dogs that are poor
anesthetic risks, or for animals that
require thoracic surgery. The animals
are all intubated with endotracheal
tubes for a clear airway during anes-
thesia, and then are draped with sterile
drapes, the same as in operating room
procedures for a human.
A central service department cleans
and sterilizes instruments, drapes, and
equipment. Most of our surgery is done
in the afternoon since this is a teaching
university. The mornings are free for
lectures and clinic office hours.
Very few patients are lost during
surgery. Intravenous stimulents, oxy-
gen, and respirators are available if
needed. The use of intravenous saline
dextrose and whole blood transfusions
is common.
Research
The research work done in this de-
partment may be of help in human
surgery some day. I have had a small
part in helping with some work done
on research of bone healing. This was
carried out on rabbits as a postgraduate
study. Another beneficial research pro-
gram is one that has been done on
Legg-Perthes' disease. This may prove
beneficial to children. Hip prosthesis
was pioneered on dogs a few years ago.
Not a deserter of people
I noticed that a reporter headlined
me in a column last year as a "deserter
of people." However, I still have a
close relationship with people through
their family pets. Pet owners are a very
devoted lot. They like to see their pet,
who is just like one of the family, get
the very best care possible. If I am
helping in some small way to do this.
then I have not let "people" down. 0
MARCH 1%7
Imagine if there were ten ways to
tell time. Suppose half the people on
highways drove on the left side as
a matter of choice. What if there was
a dispute as to whether to stop or go
on a red light.
It is obvious that many things that
we take for granted in our lives have
been standardized for convenience and
safety.
There is even considerable stan-
dardization within individual hospitals.
However, there is little standardiza-
tion from hospital to hospital, and
this creates problems. One special
aspect of this is standardization of
medical-surgical supplies and equip-
ment. As early as 1931 the United
States government set up a committee
to investigate this, but the battle to
standardize has been a losing one.
There are still as many techniques of
doing a procedure as there are doctors
and nurses in a hospital.
One example from a manufacturer
concerns needle sizes. "There are few
doctors or nurses who would know any
difference between a 20-gauge, 1 h-
inch needle and a 21-gauge, 1
-inch
needle if they did not read the label.
Yet there are as many different sizes
as there are users in some hospitals !"
One hospital had been using 10
different sizes of needles; a product
manager convinced the staff to use
just three standard sizes for a one-
month trial. One month later they
wondered why they had ever needed
all the other sizes in the first place.
Individual preference
The individual doctor, by law, is
MARCH 1967
Stan dard ization
Many things we take for granted have been standardized for our convenience
and safety. Would greater standardization in products and procedures
help our patients?
George T. Maloney
Mr. Maloney is Vice-President in charge
of Merchandising for C.R. Bard, Inc.,
Murray Hill, New Jersey. This article is
adapted from a speech presented to the
Mid-West Hospital Association Annual
Convention in Kansas City last fall.
allowed to practice the art of healing
according to his own discretion. More
uniformity in teaching in medical
schools would help to reduce the
various whims of the individual doc-
tor. The same applies to nursing
schools.
Today, commercially prepareä, pre-
packaged, preassembled, presterilized
tray setups are coming on the market.
A host of manufacturers are preparing
them. These people recognize the im-
portance of the concept of a standard
"for one and for all" if there is to be:
· more convenience
· better service
· smaller inventories
· assured quality
If hospitals will not accept a stand-
ard setup they will get greater ag-
gravation.
Nurses may already have experienc-
ed some of the problems associated
with specially-prepared sets. "It's
late!" "Something's missing!" "They've
used the wrong item!" Then it begins
- phone calls, questions, answers,
promises, explanations.
How efficient would any central
service be if it had to prepare 10 to
20 variations of the same setup? How
much higher are costs when special
parts must be purchased for the varia-
tions as opposed to the cost-saving
of quantity purchase? How much
more storage space is required if sever-
al variables of an item must be stocked
according to glove size, needle size,
syringe size, and so on ?
Compound these problems by
1,452* hospitals in Canada and you
have an idea of the number of poten-
tial problems facing manufacturers
and dealers.
High costs of specials
Manufacturers, because of compe-
tition, have catered to these individual
preferences and have made "specials."
In other words, the salesman is told
that if the tray is not prepared special-
ly for that hospital, it will be ob-
tained from another manufacturer.
*Dominion Bureau of Statistics, List of
Canadian Hospitals (83-201) 1965, p. 6.
THE CANADIAN NURSE 47
However, if this trend continues,
prices will have to rise.
An excellent analogy is what has
happened in the automotive industry.
From Henry Ford's "I'll paint it any
color as long as it's black" concept,
there is now a huge range of models.
A spokesman for Ford stated that
it is conceivable that they could go
through an entire year without making
two identical automobiles. It does not
take much "gray matter" to under-
stand the reason for the high cost of
an automobile. Many people believe
that as volume goes up, price comes
down. The converse of this is true in
the automobile industry because most
cars are "specials."
Hospitals often fail to understand
the reason for a higher price on a
special. For example, if their special
is created by removing a part, some
believe that the price of the tray
should be reduced proportionately.
What has to be taken into considera-
tion is not only the cost of the part;
when there is deviation from a stand-
ard product, closer supervision and
more production training is necessary
because more problems are created.
With a standard product, prod-
uction follows a pattern and those
involved develop a greater degree of
skill. This naturally leads to greater
ease in training employees, and
greater proficiency of work. Also, aU
manufacturing costs, particularly low
labor and inventory costs, mean less
money tied up in production. The
customer then receives a quality
product at a lower price.
Standardization will come
Manufacturers, doctors, nurses, and
hospitals are all in the business of
providing safe, effective, quality
patient care. Standardization will
help, but all will have to coordinate
efforts to achieve it.
First, simple, honest communica-
tion is essential. At many a conven-
tion, someone has stopped by our
booth and requested a "speciaL" After
he has been told about the time,
trouble, and expense necessary, and
that there was no guarantee that the
product would satisfy, he invariably
expressed thanks and understanding
of the problem.
Second, a natural evolution will
occur, because neither the hospital
nor the dealer will be able to eval-
uate all the new products introduced
each year. Dealers will influence the
tendency to standardization. They do
not have the space for four variations
of the same tray, nor the time to learn
the selling features. The space pro-
blem need not be elaborated as every-
one is aware of the problems of keep-
48 THE CANADIAN NURSE
ing up with space demands caused
by disposables. However, the cost
and disadvantages of returning to
reusables is obvious. As the fellow
said: "Horse travel doesn't cost as
much as going by jet, but who is going
to travel by horse?"
To be profitable, disposable business
must be done on a volume basis. Com-
petition will eventually force manu-
facturers to standardize or get out
of certain areas.
Third, the introduction of electro-
nic equipment and items such as the
dataphone will help to bring stand-
ardization. Recently, eight hospitals
in an area organized to share com-
puter facilities to improve patient ser-
vice and hospital administration. The
new system will help control inven-
tories of more than 2,500 different
stock items and will provide greater
economies in supply purchase. These
eight hospitals have had to come to
agreement on basic items.
Fourth, labor problems will also
bring standardization more quickly.
Hospital rates are rising rapidly as
higher salaries are obtained by nurses
and other hospital employees who
have been underpaid in past years.
Hospital administration will aim for
increased efficiency and one way will
be through increased standardization.
A fifth factor affecting standard-
ization is that the practice of medi-
cine is changing. Dr. Oscar Creech, Jr.,
Professor of Surgery and Chairman of
the Department at Tulane University
School of Medicine, recently predicted
that by 1990 medicine will be prac-
ticed on an assembly-line basis. He
pointed out that neither patients nor
physicians are ready for such changes,
but radical changes in the practice of
medicine are inevitable and the pro-
fession must prepare for them so as to
dictate in some measure how they will
occur. Standardization of equipment
and supplies will play a part if this
prediction becomes reality.
In the United States, the Federal
Government is becoming increasingly
involved in the medical industry, and
with Medicare it will become even
more concerned with costs. It is to be
hoped that the industry itself will un-
dertake cost control and not invite the
government to take over.
Manufacturer's goals
Manufacturers must meet the crite-
ria of quality of the medical industry
in all products. Each item must be of
a quality that is adequate for its spe-
cific purpose. Therefore, the purpose
must be spelled out before work can
begin on a product. Again, communi-
cation between user and manufacturer
is essential as trial and error evalua-
tion help to elucidate additional factors
and more useful methods.
Many techniques of communication
may be used:
1. Questionnaires are devised for
each specific product. These are kept
simple and concise, but include a com-
ment section. Some questionnaires are
sent by an agency so that the manu-
facturer's name is not used; others are
designed to be used by salesmen during
a "market test" phase of a product.
2. Consultants are sent to approxi-
mately 100 hospitals to check out var-
ious aspects of a product in the actual
situation. Monthly reports are sent in
on the product.
3. Recently, an advisory panel has
been used effectively. The panel for
an item used in nursing would include:
five nurses from the nursing adminis-
tration office (either the director or her
associates); three operating room su-
pervisors; nine central supply super-
visors; one nurse from the intravenous
team; one nurse with special interest in
research and development; and one
purchasing agent.
The panel meets for a day to pre-
sent concepts and prototypes and to
evaluate existing products. The atmos-
phere is relaxed and informal and cri-
ticism is encouraged.
4. Organization within the industry
can also help. A new group of market-
ing people from 31 companies held a
meeting at which competitors sat to-
e-ether and agreed that they could, and
should, work together toward certain
aspects of standardization.
Identical goals
Standardization will benefit patient
care, but it needs cooperation and
communication and time.
In a recent editorial in the Journal of
the American Hospital Association ma-
gazine, Hospitals, it was stated: "A
need exists for more standardization,
simplification, higher standards, bet-
ter communication, more efficient
marketing techniques, and more co-
operative efforts by hospitals and in-
dustry to develop products for hospital
use... Better communication between
hospitals and supply firms is also
needed about product research and
development and also use of equip-
ment and supplies in patient care...
Hospitals should not only be willing
to assist industry by discussing in use,
patient-care factors that may affect
proper design, but also should realize
that this is a continuing responsibility
of the hospital field. Industry, on its
part will find that involving profes-
sional and hospital personnel early in
the development stages of hospital
equipment will be advantageous..."
This sums it up quite solidly. 0
MARCH 1967
Hospital and health care
- what price?
Almost daily, news media make
Canadians aware of skyrocketing hos-
pital costs. While all this informa-
tion is of great interest to the indi-
vidual, it unfortunately fails to reveal
how much of the total cost is diverted
from one's personal income. If one
considers all the various types of taxes
to which one's income is subjected,
it becomes clear that it would be an
exercise in futility to attempt to com-
pute any given individual's share of
hospital costs.
Hospital operating costs
Public general hospitals, with few
exceptions, come under provincial
jurisdiction. It is left to provincial
governments to negotiate with hos-
pitals, individually, to determine the
amounts that each hospital is entitled
to receive in order to offer hospital
care to those requiring it.
However, in the Canadian system
of taxation the federal government
collects a part of the taxes earmarked
to pay hospital costs, which in turn
are transferred to the provincial gov-
ernments. As the amounts received
from the federal government cover
approximately half (depending on the
province involved) of shareable hos-
pital costs, it remains to the province
to raise most of the remaining balance.
This is accomplished through various
tax-raising programs and, in some
provinces, through direct contribu-
tions from individuals.
In some provinces, authorities may
MARCH 1967
Often we are informed that the local hospital's costs have increased 20 percent
in the past year. This raises the question of how much each individual
is going to have to supply to cover the increase.
S. J. Maubach, B. Comm., CA.
raise funds to reimburse hospitals for
their costs through a combination of
the foregoing methods. For instance,
in Ontario a married man must pay,
or have paid on his behalf, $6.50
per month to the provincial plan for
prepaid hospital care. However, the
total collected by the province in this
manner is insufficient to provide
enough funds to reimburse hospitals
for the province's share of costs and
it therefore becomes necessary to al-
locate monies gathered from some
other source to the hospital cost pool.
In Quebec, individuals do not make
direct payments to the provincial
government in the form of premiums;
the provincial government's share of
hospital costs is financed through
general tax programs. In British
Columbia, yet another innovation is
found. Each hospital patient must
pay one dollar per day to the hos-
pital while he remains in the institu-
tion, in addition to the amount he
pays to the government.
Here then we see the individual
may pay for hospitalization to three
parties: the federal government, the
provincial government, and the hos-
pital in which he becomes a patient.
These are but a few examples to il-
lustrate how complicated it would be
for any individual to determine how
much one actually does pay toward
hospital costs.
Mr. Maubach is Lecturer, School of Hos-
pital Administration. University of Ottawa.
Furthermore, it must be noted that
most provinces do not reimburse each
hospital its total costs incurred in
the treatment of patients. For in-
stance, in all provinces except Mani-
toba, depreciation on hospital buil-
dings must be absorbed by the hos-
pital. Interest on capital debt is not
generally covered in reimbursement
formulas except in Alberta and Mani-
toba.
Hospital capital costs
Up to now mention has only been
made of the funds required in the day-
to-day operations of the hospital.
Where does the money come from to
build the hospital in the first place?
As with operating costs, both federal
and provincial governments are invol-
ved in financing part of the capital
required to construct and partially
equip hospital facilities.
These two levels of government
combine to underwrite, in most cases,
a large portion of the total cost; the
amount varies from province to pro-
vince. However, the federal program
is constant for each project. It is there-
fore left to most hospitals to find other
sources of funds to finance that por-
tion of capital costs not provided for
by federal and provincial authorities.
These funds are derived from several
possible bodies - municipal govern-
ments, philanthropic organizations,
religious orders operating the hos-
pitals, and, needless to say, you and I.
THE CANADIAN NURSE 49
Federal
Government
Taxes
Tax-Shared Programs
Provincial
Government
Individual
Charges
Not Paid by Plan
Donations
Prope y Taxes
Municipal
Government
Religious
Bodies
CHART 1
Philanthropic
Bodies
Source and allocation of
hospital funds
It might be well to follow the flow
of funds to their final destination -
the hospital. Taxes collected by the
federal government are passed on to
the provincial governments under an
established formula. This money goes
into a provmcial hospital pool. The
provincial government raises money
from taxes or premiums, or both, and
these are also allocated to the hospital
pool. This pool of funds is then distri-
buted to individual hospitals based
on a negotiated budget, or other
similar planning and control devices,
which is meant to repay the hospital
for approved costs incurred in treat-
ing patients in a standard ward.
Should the patient prefer accommoda-
tion superior to that of the standard
ward, it is necessary that the indivi-
dual pay an extra fee to the hospital.
These extra funds obtained by the
hospital are sometimes shared with
the province and the portion retained
by the hospital is meant, in part, to
cover losses suffered by the institu-
tion. (Chart. J.)
Not to be forgotten are those hos-
pitals which serve the outpatients of
50 THE CANADIAN NURSE
A Public General
Hospital
the community. In varying degrees,
most of the provincial plans do not
reimburse the hospital for the entire
costs, sometimes substantial, incurred
in rendering this service.
Table 1
Projected 1966 Expenditure on
Personal Health
Services and Facilities]
Cost
Per Capita
Service
Physicians
Dentists
Other Health Services
Health Insurance Admin.
Prescribed drugs
Hospital Services
TOTAL SERVICES
HEAL TH FACILITIES:!
TOTAL
$ 24.91
8.00
7.14
4.68
7.56
73.89
$126.18
8.27
$134.45
I. Royal Commission on Health Services.
Volume I. Queen's Printer, 1964, p. 843.
2. Ibid., p. 851.
Other health facilities
While this article has so far been
restricted to the hospital field, some
reference should be made to other
health care costs in order that some
idea may be given of the magnitude
of the total health care picture which,
directly or indirectly, must be paid
for by the tax-paying public.
The anticipated cost of health care
in Canada in 1966 shows that $134.45
would be spent for every man, woman
and child. While the major portion
goes to hospital services, $60.56 per
man, woman and child will go to other
services and health facilities. (Ta-
ble J.)
While the figures in the table give
a rough indication of total health
care costs, it should be pointed out
that they are shown on a per capita
basis. If you happen to earn higher
than average income, your share of
the cost is substantially higher.
Even though it now appears impos-
sible to determine how much we, as
individuals, pay toward hospital and
other health care costs, we undoubted-
ly receive much better care than our
forefathers did. However, in view of
the rapidly changing nature of health
services offered to us, the day will soon
arrive when the politicians, health
care leaders and the Canadian public
must determine how much income is
being spent and should be spent for
our well-being. 0
MARCH 1967
research abstracts
The following are abstracts of studies
selected from the Canadian Nurses' As-
sociation Repository Collection of Nursing
Studies. Abstract manuscripts are prepared
by the authors.
Buchan, Irene M. A Study of inadive
nurses in Alberta, Canada, to determine
selected characteristics, reasons for in-
acti,'ity, and the extellt to which they
represellt a potential nursing resource.
Seattle, 1966. Thesis (M.N.) University
of Washington.
The study was done to determine: l. the
characteristics of inactive nurses; 2. the
reasons for their inactive status; and 3. the
extent to which inactive nurses planned to
return to full-time or part-time nursing
employment.
Data were gathered by a questionnaire.
The respondents comprised 374 inactive
nurses in Alberta. Data from the question-
naires were tabulated according to four
categories: l. nurses who had already re-
turned to active nursing; 2. inactive nurses
who planned to return to active nursing;
3. inactive nurses who were uncertain about
returning to active nursing; and 4. inactive
nurses who did not plan to return to nur-
sing. In order to present a composite
picture of the inactive nurse, data from
the questionnaires of the latter three
categories were tabulated and analyzed.
Questionnaires of 43 nurses who were al-
ready re-employed were deleted from the
study, leaving a total of 331 inactive nurses
as the study population.
The findings indicated that the respon-
dents represented a considerable potential
nursing resource. A composite picture of
the inactive nurse was presented. 1 he three
main reasons for inactivity given by the
majority of the non-practicing nurses were
concerned with home and family respon-
sibilities, arrangements for care of children,
and personnel policies. Recommendations
for further study were made.
Neylan, Margaret S. The del'elopment 01
an e,'aluation Q-Sort; a study of nursing
instructors. Vancouver, 1966. Thesis
(M.A.) University of British Columbia.
The purpose of this study was to develop
an Evaluation Q-Sort and to test it by
measuring the perceptions held by nursing
instructors on the relative importance of
five functions and effects of evaluation.
The functions and effects identified for
study were: the measurement of student
achievement; the measurement of student
MARCH 1967
progress; psychological effects of evalua-
tion; the influence of evaluation on teach-
ing; and the influence of evaluation on
administration. An Evaluation Q-Sort was
developed and used to measure the percep-
tions of evaluation held by the III nursing
instructors in the 6 professional nursing
schools in the Lower Mainland and Van-
couver Island areas of the Province of
British Columbia.
The population was divided into 10 clas-
sifications according to various criteria
related to role, experience, preparation, and
instructional setting. The central hypothesis
assumed that the group of instructors as a
whole would not assign greater importance
to anyone of the 5 functions and effects
of evaluation. The 9 sub-hypotheses assum-
ed that the perceptions of evaluation held
by nursing instructors would not be in-
fluenced by the variables selected for study.
The .05 level of significance was used in
the study.
The results indicated that the nursing
instructors did ascribe significantly dif-
ferent degrees of importance to the 5 func-
tions and effects of evaluation. Measure-
ment of student achievement was ascribed
least importance and measurement of stu-
dent progress was ascribed most importance
among the functions and effects studied. In
addition, differences were found with res-
pect to the nature of the instructors' res-
ponsibilities, the type of school in which
she taught, and her stated level of satisfac-
tion with preparation as an evaluator. No
differences were found with respect to
length of experience in nursing service or
education, preparation as an instructor,
course in tests and measurements, instruc-
tional focus, and instructional setting.
Arpin. Kathleen. A study to identify dif-
ferences, on selected factors, between
uni,'ersity-qualified students who are
enrolled in the first year of a bac-
calaureate or a diploma program in
nursing. Boston, 1965. Field Study,
(M.S.) Boston University.
The study was undertaken to identify
the differences, on selected factors, be-
tween university-qualified students who were
enrolled in the first year of a baccalaureate
program or a diploma program in nursing.
The subjects selected for study were
students enroIled in the first year of two
baccalaureate programs in nursing and uni-
versity-qualified students in one diploma
school of nursing. The schools taking part
were located in large metropolitan cities
in approximately the same geographical
area.
Data were coIlected by means of a mail-
ed questionnaire, administered by faculty
members, which was developed to obtain
information on the student's social class,
social background, educational background,
reasons for selection of school, interest
in further education, and other related
factors that might influence a student's
selection of a particular type of school.
The responses to the questions were com-
pared and the differences and similarities
described.
The findings indicated that there were
differences and similarities between the
two groups. The major areas of difference
were in social class, reasons for selection
of school, interest in further education.
and in social background on the items relat-
ed to parental attitude toward university
education. There was little or no difference
between the two groups on the remaining
items used to gain information on social
background, educational background, and
on the other related factors that might have
influenced a student's selection of a parti-
cular type of program.
Recommendations include: l. that a
more definitive study of all students in
grade 13, who have been accepted in either
a baccalaureate or a diploma program, be
done to determine the differences between
the two groups, and 2. that a study of
parents of grade 13 students who have been
accepted in either a baccalaureate or a
diploma program be done to determine
their attitude toward university education
for their daughters as compared to the
students.
Lennie. Clara May. A study of student
achie,'ement in an A Iberta hospital school
of nursing in relation to selected char-
acteristics of the mother. Seattle, ]965.
Thesis (M.N.) Univ. of Washington.
The purpose of this study was to explore
the relationship between achievement of
the student nurse in a diploma program
and selected characteristics of the mother.
A questionnaire, given to 236 second
and third-year students, provided informa-
tion about the mother's characteristics and
other biographical data. School records
were reviewed for student achievement.
The data revealed little relationship
between the achievement of the student
nurse and characteristics of the mother as
measured by her preparation as a nur
e or
(Continued on page 52)
THE CANADIAN NURSE 51
research abstracts
(Continued from page 51)
in a related health field, level of education,
present and past occupation, income, and
by the mother-daughter relationship. There
was some indication that the younger,
single student who entered nursing directly
from the parental home in which both
parents were living together, received higher
grades in nursing fundamentals, micro-
biology, and pharmacology II. The older
student obtained higher grades in introduc-
tion to disease, and medical-surgical nur-
sing. When mothers were employed before
marriage, daughters did better in social
sciences. Students from larger families,
daughters of mothers employed part-time,
daughters of mothers currently employed
in a hospital, and daughters who thought
parents should guide them in career choice,
received higher grades in several measures
of achievement.
Baribeau, Pierrette. A study of expressed
attitudes of Lamaze fathers toward labor
and deli\'ery experience. Boston, 1964.
Thesis (M.Sc.) Boston University.
This exploratory study is concerned with
the father's attitude toward the labor and
delivery phase of his wife's pregnancy.
The investigation was conducted within the
realm of the Lamaze method of childbirth.
It was assumed that by defining the father's
role during this important event, the Lamaze
method was contributing to the reduction
of the father's anxiety by an increased feel-
ing of participation.
The sample included six fathers whose
wives had had a succesful labor according
to the Lamaze method. The fathers were
present only during the labor period. Four
of the fathers were doctors, one was an
architect and the sixth was an assistant
researcher. Three were having their second
or third experience with the Lamaze
method of childbirth; for three, it was
their first experience.
The method of data collection was a
partially structured interview with open-end-
ed questions. The interviews were conduct-
ed in offices, restaurants or in waiting-
rooms. The responses were recorded verb-
atim with the aid of a tape recorder.
The data were analyzed in relation to
the father's attitude toward childbirth,
labor, role perception, and the influence
of his participation on these attitudes.
In conclusion, it appears that the Lamaze
fathers, as they gained more experience
with the method, also gained more confi-
dence in the value of their participation.
They expressed less anxiety verbally and
in their reported behavior as long as they
were allowed to be with their wives to assist
them. They agreed that the Lamaze method
52 THE CANADIAN NURSE
is a support to the father because of the
knowledge given, the defined task, and
the rationale for active participation of
the husband in the childbirth process. Some
fathers expressed the belief that having
something to do was a help to them. Their
encounter with the Lamaze method left
them with a feeling of satisfaction and a
positive attitude toward childbirth.
Consequently, it is recommended that
prenatal classes should stress the import-
ance of usefulness of the father in the
antepartal and partal period. Such classes
should include, beside the usual knowledge,
a better delineation of the father's role.
Nurses should be aware of the father's
need for a role definition and be prepared
to supply such information. Furthermore,
a study should be made to ascertain the
degree of decreased anxiety experienced
by the Lamaze fathers as compared to
the amount of anxiety of other prepared
fathers.
McKinnon, M. Barbara, Sister. Coordination
within tire educatioMI program in hos-
pital schools of nursing. London, 1965.
Thesis (M.Sc.N.) Univ. of Western
Ontario.
This study was designed primarily to
determine the need for greater coordination
within the educational program as perceiv-
ed by directors, teachers, and head nurses
participating in selected hospital schools
of nursing programs. The project investi-
gates four main aspects of coordination,
namely: 1. the perceived need for coordina-
tion, the degree of this need, and the
reasons underlying it; 2. the functions that
may conceivably be included in coordina-
tion; 3. an assessment of how well coor-
dination is currently carried out; the re-
cognized need for modification of activities,
Toul!h
The 900 people who have
joined Canadian University
Service Overseas took on a
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and how this modification may be effected;
4. the persons deemed most suitable to
effect coordination, and their desirable
qualifications.
Since only 5 of the 63 diploma schools
in Ontario employ an educational coordin-
ator, it seemed pertinent to explore the
reactions of these coordinators regarding
their recent appointments and the extent
of their contribution to the school program.
Findings from the study indicate the
expressed need for greater coordination
within the educational program in hospital
schools of nursing. Evidence points to the
advisability of charging one person within
a school faculty with the primary responsi-
bility for coordinating the educational pro-
gram. The research data from this project
should be assessed within the framework
of further definitive study of the whole
organizational pattern and allocation of the
many functions involved in implementation
of the educational program.
Bell, Franc" E, A study of programs in
selected schools of nursing to determine
the liberal education content of the
curriculum with specific reference to
learning experiences related to nursing
of the aged. London, 1966. Thesis
(M.Sc.N.) Univ. of Western Ontario.
This survey study explores the liberal
education content of the curriculum of
four purposely selected schools of nursing,
with specific reference to learning ex-
periences related to nursing of the aged.
None of the schools in the sample are
associated in the traditional manner with a
hospital; two are located within multidisci-
pline institutions, and two in single dis-
cipline institutions.
Through the use of a questionnaire, data
were collected pertinent to the following:
the general education prerequisite for
entrance; what comprises the general educ-
ation component; the means used to liber-
alize the professional education component;
and how these are utilized with specific
reference to learning experiences related
to nursing of the aged. This study is not
intentionally either comparative or evalu-
ative in relation to these curricula.
Recommendations arising from the find-
ings in the study include: 1. repetition of
the project using a larger sample with the
possible development of tools for purposely
comparing and evaluating the curricula
studied; 2. research into what comprises
the most appropriate general education
background for entrance into basic schools
of nursing; 3. further exploration through
research and the continuing refinement of
the curricula in schools of nursing to ascer-
tain how these may be optimally liberalized;
4. strengthening of the general education
and professional education preparation of
teachers in schools of nursing to maximize
their contribution to the liberalizing of the
curriculum.
MARCH 1967
,
".
o
Ie
books
Nursing Care of the Adolescent by S.L.
Hammar, M.D. and Jo Ann Eddy, B.S.,
R.N. 232 pages. New York, Springer
Publishing Company, Inc., 1966.
Reviewed by Mrs. S. Lyons, nursing
service supervisor, The Montreal Chil-
dren's Hospital, Montreal, Quebec.
This text is informative, realistic frank,
and practical. By discussing the normal
phases of adolescence, and by explaining and
interpreting the confusing physical and
emotional changes that occur, the authors
answer many questions and clear up com-
mon misconceptions.
Dr. Hammar and Miss Eddy bring forth
an important concept when they deal with
the feelings of the nurse as well as those
of the adolescent. They point out the need
for the nurse to understand her own feelings
before she can effectively cope with those
of the adolescent and thus establish good
rapport.
The emotional responses and the be-
havioral changes of the "normal" adoles-
cent are discussed, and ways of helping
him handle them are presented. In ad-
dition to stating a principle to be followed,
examples of the "how" are included, which
make the management more concrete and
meaningful. This is followed by a discus-
sion of illness and the additional stress that
this places on the teenager due to his hyper-
sensitivity and uncertain self-image.
Most nursing texts deal primarily with
diseases and nursing care; however, this
book emphasizes normal teenage growth,
development, and behavior. The many
unique problems confronting the sick ado-
lescent, either physically or emotionally,
are discussed within this context. Each
chapter of this paperback is followed by a
summary and suggested reference readings.
This book would help those dealing with
adolescents in sickness or in health, at home,
at school, or in hospital. It simply and
directly discusses the many and unique
problems confronting the adolescent, and
explains the inconsistent behavior character-
istic of this age group, for example, resolu-
tion of the conflict between dependency and
independency.
The authors' stated objective is met. "This
book is not intended to be a comprehensive
discourse on adolescence, for it neither
covers the entire field of adolescence, nor
details all illness found in this age group,
but we hope that it will be a useful hand-
book."
MARCH 1967
Continuity of Patient Care: The Role of
Nursing edited by K. Mary Straub, R.N.,
Ed.D. and Kitty S. Parker, R.N., M.S.N.
232 pages. Washington, The Catholic
University of America Press, 1966.
Reviewed by the laJe Dr. Katherine Mac-
Laggan, director, School of Nursing,
University of New Brunswick, Fredericton,
N.B.
The editors have done a yeoman job in
their attempt to present a report of the
1965 Workshop of the School of Nursing
of the Catholic University of America. This
workshop was "designed to consider the
responsibilities of nurse practitioners in as-
suring continuity of patient care."
The report is presented in two parts:
presentation of main topics, and summaries
of seminar proceedings. The first part is
composed of the papers presented by com-
petent authorities, followed in some cases
by discussions of these papers. The second
part summarizes the discussion and the
deliberation of the group sessions. Every-
one familiar with the workshop technique
DIRECTORS
AND
ASSIST ANT
DIRECTORS
tJ
WORKSHOPS ON
PROBLEM-SOLVING
learn and practice problem-
solving skills applied to
Hospital Nursing Service
Have you registered?
Halifax April 11-14, 1967
Vancouver May 2-5, 1967
It s later than you think!
Write to:
CANADIAN
50 The Driveway,
Ottawa 4, Ontario.
NURSES' ASSOCIATION
will accept that repetItIon is unavoidable,
and, of course, repetition is evident in this
report.
Details, such as demographic data, and
legislation affecting maternal and child
health services and mental health services,
are American in orientation, but the inter-
pretation of these details is applicable to
the Canadian situation.
All nurses, to say nothing of the power
figures in Canada who make the big deci-
sions about health, such as doctors, ministers
of health, government officials, and admi-
nistrators of health services, should read
the report to broaden their horizons on
the meaning of continuity of patient care.
For instance, Dr. Eleanor P. Hunt, a
consultant on biostatistics to the research
division of the Children's Bureau in Wash-
ington, says:
"The health professions then have
changed from their traditional role of im-
provement of the physical ills of an indi-
vidual on a personal basis to community
based action leading to the prevention of
disease and the correction of all physical,
economic, emotional, and spiritual problems
surrounding illness."
While this has been said before in many
conteAts and in other words, it still counts
as big news for those who make decisions
and ensure action.
To nurse educators, the report has im-
plications for curriculum development. To
nurse administrators, it indicates the ex-
tent to which the base of operation in nurs-
ing services must be widened. To nurse
practitioners, it provides some insight into
the magnitude of the nursing role in con-
temporary society.
Gynecologic Nursing by John I. Brewer,
M.D., Ph.D., Doris M. Molbo, R.N.,
Ph.B., and Albert B. Gerbie, M.D. 171
pages. St. Louis, Mosby, 1966.
The subtitle calls this "A textbook con-
cerning nursing through an understanding
of the patients themselves and their gyne-
cologic problems." It is directed toward
aiding the student to develop good judg-
ment in patient care, rather than toward
providing her with vast stores of facts. The
book outlines some guides in human rela-
tionships as well as the necessary facts and
procedures of gynecologic nursing.
Because the authors have prepared a
book that will assist nurses to make judg-
ments, much of the content involves con-
THE CANADIAN NURSE 53
books
cepts that could be applied to all patients
in hospital. Chapters on "The Essence of
Nursing," "The Preoperative Patient," and
'The Postoperative Patient," contain much
material that is applicable to all surgical
nursing, yet the approach is such that it
is in no way repetitive.
When the size of the book is considered.
for it is a slim volume, one is impressed
by the thoroughness and completeness of
the material and the clear, concise method
of presentation. h is an easy book to read.
At the end of each chapter, lists of re-
commended reading for students, patients
and instructors are given.
The second chapter of the book, "The
Patient's Symptoms," presents the three
main gynecological symptoms: bleeding,
pruritis, and pain. This discussion of symp-
toms, and their meaning to both patients
and nurses, provides one of the best intro-
ductions to patient understanding to be
found in a nursing text. A thorough expla-
nation of the psychological basis of symp-
toms is supplied. The section on pain is
excellent and should be read by every
nurse.
Gynecologic Nursing deserves consider-
ation as a text in schools of nursing, and
as well should be available on every ward
that has gynecologic patients. It mi:;ht
also be required reading prior to 1riservice
discussions for graduate nurse ç .
Maternity Care in the World, Interna-
tional Survey of Midwifery Practice
and Training. Report of a Joint Study
Group of the International Federation of
Gynaecology and Obstetrics and the In-
ternational Confederation of Midwives.
527 pages. 1966. Toronto, Pergamon
Press.
Reviewed by Miss Frances Howard, nurs-
ing consultam, Canadian Nurses' Associa-
tion, Ottawa, Ontario.
Another first has been added to the in-
creasing body of infonnation on world
health services. Through the joint effort of
the InternationaJ Federation of Gynaecology
and Obstetrics and the InternationaJ Council
of Midwives. a world survey of maternity
health services was begun in 1961. Maternity
Care in the World is a compilation of the
data obtained through this survey.
The purpose of the study was to inves-
tigate the training and practice of midwives
throughout the world. However the study
group recognized the need to obtain other
kinds of infonnation related to the practice
of midwifery. Vital statistics on maternal
health services as well as information on
the training and practice of midwives was
obtained.
One hundred and seventy-four countries
54 THE CANADIAN NURSE
CNA's Repository Collection of Nursing Studies
Next month. Canadian Library Week will be observed. Last year THE CANADIAN
NURSE recognized a sister association's special week by a feature article on the CNA
Library. This year it seemed appropriate to describe a rather unique aspect of the library
service, the CNA Repository Collection of Nursing Studies.
Four years ago the decision was made that the Canadian Nurses' Association
would establish and maintain a collection of nursing studies. When the CNA library
was established on a formal basis in 1964, this collection became the responsibility of
the library.
The collection now contains some 90 studies, and includes master's and doctoral
theses and studies by government organizations and institutions. Their scope varies
from major surveys of large areas or topics to investigations of relatively small scope.
The only governing criterion is that the study is on a subject of concern to nursing in
Canada, or, in the case of a thesis, was conducted by a Canadian nurse.
The earliest study in the collection at present is the famous Weir Report, Survey
of Nursing Education in Canada, printed in 1932 by the University of Toronto Press.
This report is now out of print but is still very much in demand for schools of nursing
libraries. This demand may now be met, in part at least, by loans from the CNA
library.
Recent additions to the collection include Portrait of Nursing; a Plan for the
Education of Nurses in New Brunswick by CNA President, Dr. K.E. MacLaggan; The
Study of Nursing Education in Canada by Dr. H.K. Mussallem for the Royal Commis-
sion on Health Services; The Report of the Ad Hoc Committee on Nursing Education
in Saskatchewan (Tucker Report); master's theses from some of the 1966 graduating
class at the University of Western Ontario; and A Study of Inactive Nurses in Alberta
by Irene M. Buchan, a Canadian Nurses' Foundation scholar, submitted toward a
master's degree at the University of Washington.
Canadian Nurses' Foundation scholars are required, and other master's and doctoral
students are encouraged, to deposit their theses in the collection. Since only minimal
funds are available to assist the students to defray typing costs of a copy of their study
for the collection, many students prefer to lend us a copy with written permission to
Xerox it.
Studies deposited in the collection are shown as received in the special listings
in the CNA Bul/etin and in the accession list of the CNA library in THE CANADIAN
NURSE.
In 1964, the Canadian Nurses' Association issued an Index of Canadian Nursing
Studies (now out of print). This issue of the Index included many studies for which
copies were not available in the collection. In the revised Index the majority of the
studies are available for consultation from the CNA collection of Nursing Studies.
Now, still another key to the collection will be available in the form of selected
abstracts that are to be published periodically in THE CANADIAN NURSE.
Use of the collection as a resource tool for nursing research and studies increases
daily, both at national office and across Canada by inter-library loan. Some studies
are booked months ahead. The CNA Repository Collection of Nursing Studies, while
still young and developing, is already proving of value to the profession and to the
contributors.
were included in the study. Data are re-
ported by country and by region. A com-
mentary is included for each country. Com-
parative tables illustrating data on maternity
care and midwifery training and practice
by country and by region are included. Vital
statisticaJ data are reported for the years
1951 and 1961. In addition there is a
summary of the world situation. Included
are vitaJ statistics, by region, and a sum-
mary commentary on methods of training
and roles and functions of midwives. Prob-
lems of definition and registration which in-
hibit the conduct of global studies are
noted.
The study group recognized that recom-
mendations could not be made toward spe-
cific action in individual countries. Instead,
recommendations relate to the conduct of
similar national studies as a prelude to the
establishment of national P9licies. Similar
internationaJ studies are recommended for
the future.
It is also recommended that aJl countries
aim at establishing uniform definitions, thus
allowing for more conclusive comparative
data. Other recommendations refer to re-
gistration of midwives, aid to developing
countries, improvement of standards of
training and practice. and increased country
membership in the ICM and the F.I.G.O.
Maternity Care in tllC World is described,
in the preface, as "the end of the beginning,"
As such it is a vaJuable reference book for
all health personnel involved with maternity
services. It provides an opportunity to com-
pare progress with that of other countries
and to learn of other methods of training
and utilization of midwives. The recom-
mendations call for continued study and im-
provement and provide a directive for future
action, internationally and nationally.
MARCH 1967
R
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' I
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fr No.
510
_ ANN COHN. L.P. N.
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,íO JOHN
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MARCH 1967
books
Migraine by Harold Maxwell, M.D. 64
pages. Toronto, The Macmillan Company
of Canada Limited, 1966.
Reviewed by Miss W. Bell, director of
nursing service, The General and Marine
Hospital, Owen Sound, Onto
No.
100
While Migraine has been written essen-
tially for the medical profession by one
of its own members, this in no way detracts
from its interest for those outside the
profession, and particularly those afflicted
by headache. Since we are told in the fore-
ward that approximately one in ten of our
adult population is affected, in some degree,
by migraine, it should follow that this
publication will be widely and thoughtfulIy
read.
Many theories are expressed as to the
cause of migraine and it has been variously
described throughout the centuries. Insuf-
ficient evidence gave no real support to
the thinking of those who sought to clas-
sify it as an allergy. However, some evidence
did indicate that migraine sufferers are
more likely to be people who present
neurotic symptoms, the most notable one
being anxiety. It is thought that they pos-
sess unresolved, unconscious conflicts mak-
ing stressful life situations too difficult to
handle. Somatic, hysterical and phobic feat-
ures may also be observed. However, it
must be realized that there is no conclusive
proof that migraine is the only affliction
to which the foregoing symptoms are
linked.
The doctor-patient relationship is stres-
sed in a very positive way, and the rap-
port and relationship between the patient
and general practitioner is highly signifi-
cant, being a means of lessening tension
for the patient to a marked degree. Time,
of course, is an essential element.
The concluding chapter is a real high-
light for patients with this illness. It deals
with many of their accompanying problems
in a most practical and helpful way and
ends with the locations of the migraine
clinics situated throughout England.
No.
169
Medicine for Nurses, 10 ed., by W. Gordon
Sears, M.D. (Lond.), M.R.C.P. (Lond.).
549 pages. Toronto, The Macmillan
Company of Canada Limited, 1966.
Re
'iewed by Miss Thelma Pelley, director
of nursing, Stratford General Hospital.
Stratford, Ontario.
This text presents a concise compilation
of elementary data pertaining to the symp-
tomatology, diagnosis, and medical treat-
ment of diseases that are classified in ac-
Next Month
in
The
Canadian
Nurse
. Cancer
chemotherapy
. Changes
in Saskatchewan's
nursing
education
. Official
opening
of CNA
Headquarters
D
Photo credits
Dominion-Wide, pp. 11, 19
National Film Board, pp. 30, 32
National Health and Welfare,
pp. 30, 32, 33, 43
Miller Photo Services, Toronto,
pp. 37, 38, 41
University of Guelph, p. 46
THE CANADIAN NURSE 55
books
cordance with their relationship to parti-
cular body systems and/or functions.
In the preface to this tenth edition of
a text first published more than 30 years
ago, the author states that he has "not
materially altered the general plan or
academic level of the contents." It is there-
fore understandable that the text will
have limited relevance to any progressive
program in nursing. The title of the text,
and the author's introductory comment
that the text is designed to assist nursing
students to acquire the minimum know-
ledge of medical science required for the
writing of the General Nursing Council
examinations, suggests a simplified, in-
complete presentation of medical data.
In a disease-oriented approach, the text
does not place emphasis upon any explan-
ation of primary principles of medicine and
their application to nursing practice. The
limited scope of the presentation is illustrat-
ed by the limited introductory definitions
of "medicine" and "health," which des-
cribe medicine as "the art and science
of healing disease," and health as "the
perfect structure of all organs and tissues
of the body with a perfect performance of
all their functions." These definitions do
not express the broader concepts of pre-
ventive medicine and of the World Health
Organization definition of health which
implies not perfection but a relative state
of well-being and effective personal and
social functioning.
The format of the text is a collection of
brief, simplified definitions organized prim-
arily on a basis of the systems affected.
It would seem that the format, approach,
and content of the text tend to encourage
memorization of given factual data rather
than to stimulate a questioning attitude or
an intelligent analysis and application of
scientific principles to nursing practice.
A further illustration of the limitations
of the presentation is the fact that in the
discussion of metabolism, the emphasis is
upon disorders, with practically no refer-
ence to the normal processes of metabolic
function. There are brief comments upon
fluid needs but no reference to the phy-
siology and importance of electrolyte ba-
lance.
It is submitted therefore that this text
has little to offer the instructor, student
or practitioner of nursing who has access
to a wide selection from many compre-
hensive texts on pathology, physiology, and
pharmacology. There is also a wide selec-
tion of medical nursing texts that assist the
nurse to understand and apply the basic
principles of medical, physical, and social
sciences, which are indivisibly interrelated
to the art and science of nursing.
All nurses today are committed to an
obligation to be learners, teachers, and prac-
titioners of the art of nursing. Therefore,
the nurse of today needs the assistance of
texts that provide intellectual stimuli and
give an adequate illustration and explana-
tion of the correlation and the application
of scientific facts and principles, which are
the underlying rationale of the essential
skills exercised in the practice of nursing.
Introduction to Growth, Development
and Family Life by Dorothy Ellen Bab-
cock, R.N., B.S.N.E., M.S.N. 2d ed. 145
pages. Toronto, The Ryerson Press, 1966.
Reviewed by Denise Martin, clinical in-
structor, St. Elizabeth Hospital, Hum-
boldt, Saskatchewan.
This paperback text is divided into three
parts: part one, Self Understanding; part
two, Normal Child Development; and part
three, Maturity.
As stated in the preface, the book is
intended for those engaged in Practical I
Vocational Nursing. It is written in a very
basic and informal style with considera-
tion given to basic principles and the ap-
plication of these principles to the care
of patients. Each part is preceded by an
overview and ended with a summary, dis-
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THE CANADIAN NURSE
Heartburn's one of the worst kinds of
indigestion. And Tums are the best way
of relieving it. Wherever you are take
Tums; they need no water, taste pleas-
antly minty, act fast to bring long-last-
ing relief from heartburn, gas and indi-
gestion, and cost so little. Tums fight
acid indigestion so well because the y
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excess stomach acid - So take heart,
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MARCH 1967
books
cussion questions, and references. Through-
out the chapters there are many diagrams
and illustrations.
Part one, Self Understanding, summarizes
the concepts of personality development
and those factors that influence its develop-
ment. The "iceberg" phenomenon is dia-
gramed and explained.
Major developmental milestones and the
basic physical and emotional needs of the
individual at various age levels comprise
part two. Each chapter has a catchy head-
ing, eg., "Jet Age - Between One and Five
Years." The same pattern is carried through
to part three, Maturity.
The book fulfills the author's intention
of preparing a book, on an introductory
level, for the practical nurse and of doing
this in an interesting style.
Educational Psychology by S.R. Laycock
and H.C. Munro. 470 pages. Toronto,
The Copp Clark Publishing Company,
1966.
Reviewed by Mrs. Frederica Heasman,
R.R. # 1, Cam , lachie Ontario.
Writers of applied introductory texts
face a number of hazards for they must
try to mtroduce a subject to students who
do not have the requisite background knowl-
edge. Hopefully, the day will come when
student teachers have a background of phi-
losophy, sociology, psychology, growth and
development, etc., before they try to for-
mulate ideas about teaching.
Some authors writing for students with
limited backgrounds resort to admonish-
ing, eg., "you must accept..... or to offer-
ing simple solutions to complex questions,
eg., "the best way is to..... Others offer
much detail, obscuring the viewpoint they
seek to express.
A need exists for these texts and will
continue as long as school teachers are
being prepared in short programs in
teachers' colleges, and nursing specialists in
education, supervision, and public health
are offered postgraduate courses of one
academic year.
This text deserves wide recognition. It
has avoided the pitfalls and contributes
positively to an understanding of learning.
Some of its strengths are: I. The role of
the teacher as outlined is warm, humane,
and creative. Differences in students,
teachers, and approaches to learning are
supported, and statements made are based
on well-chosen references. 2. A skillful selec-
tion of the material presented has resulted
in a well-organized text written in pleasant
English. 3. A variety of approaches to
problems of teaching are outlined as exam-
ples of creative thinking rather than as
MARCH 1967
solutions. A basis for evaluation is sug-
gested and is integrated throughout the text
in such a way that evaluation is presented
as one process of learning. 4. It would
be difficult for a person using this text to
avoid going on to further reading in the
areas considered as the approach is broad
and the references are well used.
This text would be of value for beginning
teachers in nursing schools and for public
and occupational health nurses. It could
also help the experienced teacher who is
feeling "dried up" or discouraged.
It is a pleasant experience to read this
book. The authors' sincerity, enthusiasm,
and respect for learners remains undiminish-
ed after a lifetime of teaching.
The Nursing Clinics of North America,
vol. I, no. 3, September 1966. June S.
Rothberg, guest editor. Chronic Disease
and Rehabilitation. 533 pages. A W.B.
Saunders publication, available in Canada
from McAinsh & Co. Ltd., of Toronto
and Vancouver.
Reviewed by Mrs. J. Peitchinis, associate
professor, School of Nursing, University
of Western Ontario, London, Ontario.
Twenty nursing specialists contribute 17
papers to this "Symposium on Chronic
Disease and Rehabilitation," which prob-
ably does provide, as the guest editor hoped
it would, valuable new insight and specific
suggestions for nurses practicing in all set-
tings.
The reviewer concurs with those authors
who perceive many of the assumptions
and practices discussed in the symposium
to be applicable and imperative in all nur-
sing: there are rehabilitative aspects in the
care of most patients, and one looks
forward to the time when all nursing
practice is directed toward them, so that
the adjective rehabilitative becomes un-
necessary. The reviewer prefers the term
long-term illness or disability employed by
many of the contributors to those of chronic
disease or disability used in the subtitle,
and by some of the authors.
The symposium sets out many of the
basic assumptions underlying "rehabilitative
nursing." It discusses the assessment of
"patient need," approaches to working ef-
fectively with patients, and means for co-
ordinating all the services of the health
team. In some papers the nurse is seen as
the team leader. The role of the clinical
nursing specialist in a rehabilitation center
is described, and possibilities for nursing in
industrial health settings are suggested. Not
only is consideration given to the care of
patients with particular long-term illnesses,
but also to the process of aging, and to re-
habilitation of psychiatric and pediatric
patients. There are numerous illustrations
and patient studies to facilitate the reader's
understanding; proposals for teaching re-
habilitative care to nonprofessional person-
nel are also presented.
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of the chair and hooked together. When this
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THE CANADIAN NURSE 57
films
Fire Safety
They Called It Fireproof was produced
in 1963 by the National Film Board. In the
film, a coroner's inquest investigates the
causes of a fire that took the lives of
two patients in a supposedly "fireproof'
hospital. It shows how every individual in
the hospital has a responsibility for safety-
consciousness and constant vigilance.
The film is an excellent one for all levels
, rJæt.
,
'"
..
of hospital personnel, and should be shown
in all schools of nursing and be used ex-
tensively in inservice education programs.
The 28-minll1e, color, sound picture re-
ceived an award from the (USA) National
Committee on Films for Safety. It is avail-
able on loan for a nominal service charge
from the regional office of the National
Film Board, or from the Canadian Film
Institute. 1762 Carling Ave.. Ottawa 13.
Community Health
A useful film for student nurses learning
about community and public health pro-
grams might be A Day in the life of a
,
\
Wondersole Is contoured
to rnatch the shape of your
foot. Your body weight is dis-
tributed evenly along Its entire
length for cornplete support.
,.
'\
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'"
-
What a difference Air Step's new Wondersole makes to ycur
general feeling of well-being. It lets you walk on the entire
bottom of your foot instead of Just the heel and ball. This
allows you to walk and stand longer without strain.
For the name of your nearest Air Step dealer, write Air Step WARD
DivisIOn, Brown Shoe Company of Canada, Ltd., Perth, $15.99
o.l""'
e
:
::'"
THE SHOE WITH THE MAGIC SOLE 'Prices quoted are Suggested Retail Prices.
Air Step Division, Brown Shoe Company of Canada Ltd., Perth, Ontario
58 THE CANADIAN NURSE
MEDIC
$15.99*
Public Health Nurse. This film was prepar-
ed for television audiences and centers
around the South Okanagan Health Unit in
Kelowna, B.C. It shows some of tl}e special
services offered in the health department.
It also illustrates some of the facilities
for consultation and service from the staff
of the provincial mental health services.
The film can be obtained from the Cana-
dian Film Institute, 1762 Carling Ave.,
Ottawa 13, or from your provincial film
library. The black and white film was
produced in : 963 and runs for 12 minutes.
accession list
Publications in this list of material
received recently in the CNA library are
shown in language of source. The majority
(reference material and theses, indicated
by R excepted) may be borrowed by CNA
members, and by libraries of hospitals and
schools of nursing and other institutions.
Requests for loans should be made on the
"Request Form for Accession List" {page
60) and should be addressed to: The
Library, Canadian Nurses' Association,
50 The Driveway, Ottawa 4, Ontario.
BOOKS AND DOCUMENTS
I. Australasian hospital directory and
nurses' year book 1966. Compiled and an-
notated by A.L. Hart. Sydney, N.S.W.,
New South Wales Nurses' Assoc., 1966.
185p. R
2. Canadian annual review, 1965. Edit-
ed by John Saywell. Toronto, University
of Toronto Press, 1966. 569p. R
3. Child psychiatry. Ottawa, Canadian
Psychiatric Association Journal, vol. 10,
no. 5, October 1965. p. 423-443.
4. Comparisons of intensive nursing
service in a circular and a rectangular unit;
Rochester Methodist Hospital, Rochester
Minn., by Madelyne Sturdavant. Chicago.
American Hospital Association, 1960.
219p.
5. Examinations and their place ill med-
ical education and educational research.
Edited by John P. Hubbard. Evanston Ill.,
Association of American Medical Colleges,
c1966. 69p. (Journal of Medical Education.
vol. 41, no. 7, pt. 2, July 1966.)
6. Factors influencing continuity of
nursing service by Louise C. Smith. Study
sponsored by National League for Nursing;
directed by Institute of Research and Ser-
vice in Nursing Education, Teachers Col-
lege, Columbia University. New York,
NLN, 1962. 139p.
7. Handbook for the night super-
visor in the small hospital by Sister M.
Virginia Clare. St. Louis. Catholic Hospital
Association, 1963. lOOp.
8. Higher education ill a changing
Canada; symposium presented by Royal
MARCH 1967
accession list
Society of Canada in 1965. Edited by J.E.
Hodgetts. Toronto, Published for the
Society by University of Toronto Press,
1966. 90p.
9. Horizons unlimited; a handbook des-
cribing rewarding career opportunities in
medicine and allied fields. Chicago, Amer-
ican Medical Association, c1966. l30p.
10. How to find ollt; a guide to sources
of information for all arranged by the
Dewey Decimal Classification. Edited by
G. Chandler. 2d ed. London, Pergamon,
c1963. 198p.
I I. Manual of hospital planning pro-
cedures. Chicago, American Hospital As-
sociation, 1966, cl958. 72p.
12. The nursing clinics of North Amer-
ica, v. I, no. 4. December, 1966. Philadel-
phia, Saunders. 209p. Contents: Sympo-
sium on the nurse and the new machinery.
Ruby M. Harris, guest editor. Symposium
on mental retardation, Kathryn Barnard,
guest editor.
13. Occasional paper ':0. 64, Ottawa,
Canadian Library Association, 1966. 2 pts.
pt. I. Canadian books, pamphlets and do-
cuments on gerontology in the Library of
Parliament. pt. 2. Articles on aging indexed
in Canadian periodical index 1947-1965,
excerpted by Joan O'Rourke.
14. The operation of state hospital
planning and licensing programs by G. Hil-
ary Fry. Chicago, American Hospital As-
sociation, c1965. l34p.
15. Personal and vocational relation-
ships of the practical nurse by Marion
Keith Stevens. Philadelphia, Saunders, 1967.
258p.
16. Pharmacology for practical nurses
2d. ed. by Mary Kaye Asperheim. Philadel-
phia, Saunders, 1967. 163p.
17. The Planning of change; readings
in the applied behavioral sciences edited
by Warren G. Bennis and Kenneth D.
Benne and Robert Chin. New York, Holt,
Rinehart and Winston, 1964, c1961. 289p.
18. Psychology of human behavior for
nurses, 3d ed. Lorraine Bradt Dennis. Phi-
ladelphia, Saunders, 1967. 289p.
19. Psychology of human behavior for
nurses, 3d ed. Instructors' guide, by Lor-
raine Bradt Dennis. Philadelphia, Saunders,
1967. HOp.
20. The sister as a clinical specialist by
Sister Léon Douville and Sister Marilyn
Emminger. St. Louis, Conference of Catho-
lic Schools of Nursing, 1966. 126p.
21. Skills that build executive success.
Boston, Graduate School of Business Ad-
ministration Harvard University, 1964.
121p. (Selections from Harvard Business
Review.)
22. A sociological framework for patient
care. Edited by Jeannette R. Folta and Edith
MARCH 1967
S. Deck New York, Wiley, c1966. 418p.
23. A study of arbitration decisions by
Carl Hamilton. Toronto, United Steel-
workers of America, 1966. 84p.
24. Your health and you by H.P.
Simonson and E.A. Hastie and H.A.
Dorothy. Toronto, Macmillan, c1966.
153p.
PAMPHLETS
25. A brief to Committee on the Heal-
ing Arts. Toronto, Registered Nurses' As-
sociation of Ontario. 1966. 27p.
26. Enrolment in Canadian universities
anå colleges to 1976/77; 1966 projection,
by Edward F. Sheffield. Ottawa, Associa-
tion of Universities and Colleges, 1966.
20p.
27. An index of care by J.A.K. Mac-
Donell and G.B. Murr!!y, Ottawa, Medical
Services J. 31 :499-517, Sep. 1965. Reprint.
28. Job descriptions. St. John's, Asso-
ciation of Registered Nurses of Newfound-
land, 1966. 16p.
29. Joint statement on non-nursing acti-
,'ities carried out by nursing personnel in
some hospitals. Vancouver, British Colum-
bia Hospitals' Association and Registered
DANDRUFF
WARD
DANDRUFF
WARD
You won't see this in your hospital
We're not trying to fool you.
We're making a point'
That dandruff is a serious medical
problem and the only truly effective
treatment is the medical one - Selsun
by Abbott.
Selsun clears up annoying, unsight-
ly dandruff in two or three treatments.
(thoroughly effective in 92% to 95%
cases reported l ).
You use it like any shampoo. Works
fast. Comes in a handy unbreakable
bottle. Leaves your hair glistening.
Really, there's no room for dandruff
in your professional or social life. Use
Selsun and get to the root of the
problem.
Precautions: Occasional sensitization
of the neck and external ear may
occur. Falling hair which may accom-
pany scalp treatment is usually due to
an impoverished or diseased condition
of the hair and scalp.
1 Slinger, W. N., and Hubbard, D. M., Treat-
ment of Seborrheic Dermal,tis with a Shampoo
Containing Selenium Disulfide, Arch. Der